2010 - %3, October

Chart of the Day: Healthcare Spending

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| Fri Oct. 1, 2010 10:40 AM PDT

Dr. Aaron Carroll has finished up his series on healthcare spending, and the chart on the right shows the main areas where America overspends. In short: everywhere. Here is his summary:

It’s been interesting to read the emails I’ve gotten over the last two weeks on this series. Many of you seem to believe I’ve got some secret agenda with respect to how to fix this. I don’t. The truth is that I don’t think there is a simple solution. Some of you on the right think that increased consumer costs will fix the whole thing. It may, for some sectors, but it will do nothing in others. Plus, I think it would negatively affect outcomes. Similarly, tort reform isn’t the answer either.

Some of you on the left think it will be just as easy if you had your way. But even if we went to a single-payer system, and significantly decreased insurance costs, that won’t touch the bulk of the problem. Nor would singling out changes to pharmaceutical spending.

....The final thing is that we have to stop looking for others to blame. We are all to blame. So let’s get past blame entirely, and start dealing with the problem. Our goal isn’t to reduce our spending to that of other countries. Our goal is to reduce spending so that it is in line with GDP. It’s to get spending down to the curve in the above graph. It’s to get spending down to just the green slice of the pie.

The introduction to his series is here, and it includes links to all ten parts. It's worth a read if you want to get a quick, very readable take on why healthcare in America is so expensive without producing results any better than all the countries that spend less than us.

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Scientist Finds High Levels of Carcinogens in Gulf

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| Fri Oct. 1, 2010 10:23 AM PDT

Researchers at Oregon State University are finding elevated concentrations of carcinogenic chemicals in the Gulf of Mexico as they investigate the lasting impacts of the BP oil spill. Specifically, researchers are finding high levels of polycyclic aromatic hydrocarbons (PAHs), which are found in crude oil, in some areas of the Gulf.

Via OSU's release:

Oregon State University researchers began testing for the contaminant May 9, and preliminary results, which have not yet been fully analyzed, suggest that the level of PAHs in the water off the coast of Louisiana experienced a 40-fold increase from May to June. The July data was lost when the device the OSU team uses for water sampling disappeared.
However, an initial analysis of the August data continues to show abnormally high levels of PAHs, similar to the 40-fold increase discovered earlier in the summer, said Kim Anderson, a professor of environmental and molecular toxicology in OSU's College of Agricultural Sciences.

This is a concern not only for those who are living or working in the region, but for anyone who eats Gulf seafood as well. As a recent piece published in the Journal of the American Medical Association noted, "Although vertebrate marine life can clear PAHs from their system, these chemicals accumulate for years in invertebrates." This of course raises concerns about the long-term safety of seafood—specifically, shrimp, oysters, crabs, and other invertebrates.

The researcher outlined the potential problems with high PAH levels:

In some cases, they are a significant toxicological health concern. Of the more than 100 chemicals that make up the class, a fraction of them can result in harmful health effects after exposure.
"There are a range of health effects associated with PAHs," said Anderson. "They are toxic by several different modes of action. We're now using a technique that looks at the fraction of PAHs that are bioavailable – that have the potential to move into the food chain."

There are also concerns about a specific type of PAH that contains oxygen, or OPAHs—the production of which the researchers say may have been increased by the use of chemical dispersants to break down the oil. This type is more mobile and stays in the environment longer.

Still more evidence that, just because you can't see the oil in the Gulf, that doesn't mean it's not there.

Inside the White House

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| Fri Oct. 1, 2010 9:50 AM PDT

Joe Klein isn't sure that Pete Rouse is a good choice to replace Rahm Emanuel as Obama's chief of staff:

I don't know Rouse very well. I don't know what his priorities will be. Early reports emphasized his "calming" effect and his long career as a Congressional insider. But if this no-drama White House gets any calmer, it'll be comatose. There's a need for energetic, non-Congressional, non-insider voices in the inner circle. Some wise executives like Pennsylvania Governor Ed Rendell would be welcome.

Maybe. Klein suggests that Democrats too often choose congressional insiders as chief of staff while Republicans more wisely choose energetic executives. There's something to that, though I'm not sure Republican chiefs of staff have necessarily been any more dramatic than Democratic ones. James Baker was the ultimate insider, after all, and Andy Card was about as self-effacing as they come.

More generally, though, Klein dings Obama for getting a lot of stuff through Congress but not getting a lot of credit for it. That's probably unfair. Obama has had pretty good legislative success, and the sour public mood is due far more to the long, grinding recession we're in than it is to Obama's public persona. On average, Obama is about as popular today as most other presidents at this point in their terms.

In any case, Klein will probably get his wish shortly. Rouse's influence aside, Obama is almost certain to have a far more combative, White House-centric identity if he has to deal with a Republican Congress starting in January. That worked wonders for Bill Clinton's popularity, and I imagine it will do the same for Obama's.

Grijalva Demands Info on Disappearing Oil Reports

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| Fri Oct. 1, 2010 8:50 AM PDT

About that disappearing oil: Rep. Raul Grijalva (D-Ariz.) sent scathing letters to the heads of three agencies closely involved in the response to the Deepwater Horizon oil spill this week. The congressman accuses the federal government's spill responders of using "questionable scientific data" and potentially misleading Americans about the amount of oil still in the gulf.

As we've reported here plenty of times now, there are many outstanding questions about the government's official estimates on the spill: Why were the initial estimates of the spill size so far off base? Why won't the feds release data to back-up their claims? Why wasn't the spill budget peer-reviewed, as officials indicated? Grijalva, chair of the House Subcommittee on National Parks, Forests, and Public Lands, raises all these questions and more in letters sent this week to Coast Guard Rear Admiral James Watson, US Geological Survey Director Marcia McNutt, and National Oceanic and Atmospheric Administrator Jane Lubchenco.

The letters demand all staff emails from each agency about the release, analysis, preparation, and dissemination of the oil budget report and flow rate estimates; the supporting scientific documentation for the reports and any early drafts; records of any communication with outside experts, and records of communication with news outlets on the reports. Clearly, Grijalva wants to know where all those claims about disappearing oil actually came from.

In his letters, he raised questions about the release of a government report on August 4 that indicated that the vast majority of the oil in the Gulf was gone or otherwise non-consequential. He also questioned the assertion that the report had been reviewed by independent scientists, which it apparently was not:

This gave the clear impression that the data to support the findings, as well as the findings themselves, had been subjected to a scientifically rigorous peer review process. The initial public reaction was relief that such a thorough review had found reduced risks to the Gulf of Mexico and its ecosystems and economic resources.

His letter to McNutt states that USGS has "a troubling history of premature assurances that the Horizon disaster was small and easily containable." He also questions her bizarre reference to "unknown unknowns" in their analysis of the size of the spill.

The letters also highlight a television report from New Orleans about independent scientists claiming that government actors had tried to silence their findings. Here's an excerpt from the letter to Lubchenco:

Taken together, this attitude toward independent analysis and the widely varying spill estimates do not paint an acceptable picture. The Gulf economy was shattered by the Deepwater Horizon disaster, and the people of the Gulf states and the entire nation have rightly demanded an explanation not only of how the spill occurred, but of the extent of the damage and the prospects for recovery. I am concerned that NOAA and its partner agencies have fallen short in this regard.

I'll be interested to see what the agencies provide to Grijalva, considering the trouble outside groups have had prying information from their grasp.

Where Your Taxes Go

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| Fri Oct. 1, 2010 8:47 AM PDT

A Third Way report made the rounds yesterday touting the idea of providing taxpayers with a "receipt" when they pay their tax bills every year. They provide an example, which looks like this:

Put aside the technical details for the moment. I don't know for sure if all their calculations are right. I don't know why national defense is left off their sample receipt. Medicare and Social Security are funded from a different set of taxes than everything else and therefore have to be calculated differently. I don't know how you'd divvy up the share of revenue from corporate income taxes, excise taxes, etc. For now, though, let's assume we could work out all that stuff to everyone's satisfaction.

My question is this: who would be in favor of this and who would be opposed? Would everyone's receipt show the same items, or would everyone get, say, the same top five or six and then a random mix of other stuff? Who would decide how to break things out? Would liberals be afraid that people might look at the welfare-related spending and be outraged? Would conservatives be afraid that people might look at the startlingly low numbers for everything after the Big Five (Social Security, Medicare, Medicaid, Defense, interest on the debt) and lose some of their outrage over federal spending?

Technical details aside, this is the kind of idea that everyone should support. Taxpayers should know where their tax dollars are going, after all. And yet, I'll bet that neither party would actually be in favor of this. Why do you suppose that is?

Howard Dean's Farewell to Rahm

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| Fri Oct. 1, 2010 8:41 AM PDT

From an excerpt of Ari Berman's new book, Herding Donkeys: The Fight to Rebuild the Democratic Party and Reshape American Politics:

The White House doesn't want its activists to disrupt the backroom deals its aides cut with lobbyists and legislators, nor does it want them putting too much pressure on obstructionist Democrats, lest it alienate key swing votes in Congress. When MoveOn.org ran ads targeting conservative Democrats who were blocking healthcare reform, Rahm Emanuel memorably called the ads "fucking retarded." And, indeed, the White House has expended considerable political capital denouncing the "professional left" and defending apostate Democrats like Blanche Lincoln in Arkansas from insurgent primary challengers, which has further undermined Obama's reformist brand.

"I'm not looking to pick another fight with Rahm Emanuel, but the contempt with which he held the progressive wing of the party was devastating and incredibly demoralizing," [former Democratic Party chief Howard] Dean says. "That's basically saying to your own people, You got us here, now F-you."

Emanuel received a standing ovation in the East Room from the White House staff on Friday morning when President Barack Obama officially announced his departure.

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Turning Down the Volume

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| Fri Oct. 1, 2010 8:26 AM PDT

Fellow MoJoer Nick Baumann draws my attention to a report suggesting that the U.S. Senate isn't completely worthless after all. Here's the evidence:

Legislation to turn down the volume on those loud TV commercials that send couch potatoes diving for their remote controls looks like it'll soon become law. The Senate unanimously passed a bill late Wednesday to require television stations and cable companies to keep commercials at the same volume as the programs they interrupt.

....Managing the transition between programs and ads without spoiling the artistic intent of the producers poses technical challenges and may require TV broadcasters to purchase new equipment. To address the issue, an industry organization recently produced guidelines on how to process, measure and transmit audio in a uniform way.

The legislation, sponsored by Sheldon Whitehouse, D-R.I., requires the FCC to adopt those recommendations as regulations within a year and begin enforcing them a year later. Rep. Anna Eshoo, D-Calif., is the driving force behind the bill in the House.

It's not a done deal yet: the bill still has to go to conference and then get a final vote in both House and Senate. But apparently no one expects that to be a problem unless someone throws a tantrum and decides to shut down the Senate because Barack Obama insulted their dog or something.

Anyway, this is indeed one of my great pet peeves. It's sort of like the Do-Not-Call list: I don't really care about principled arguments on either side. I don't care if this regulation should be considered liberal, conservative, libertarian, fascist, or anything else. I just want the damn volume on advertisements to go down. If the only way to do it were to put a few network chiefs in front of firing squads just to send a message to the rest of them, I'd probably favor that too. Just get it done.

Rahm and Rupert

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| Fri Oct. 1, 2010 8:03 AM PDT

Did Rahm Emanuel and Rupert Murdoch huddle together at the Obama White House?

On the day that Emanuel is departing the West Wing to run for mayor of Chicago, the Sunlight Foundation is releasing a list of the visitors he had at the White House. The usual suspects on this roster: Chicago power players (Sam Zell, Leo Melamed), lots of members of Congress, Hollywood celebs (Kevin Costner, Judd Apatow), a bunch of journalists (Jonathan Alter, Karen Tumulty, Noam Schieber, Fred Hiatt, Ryan Lizza, Ron Fournier, Candy Crowley, Tom Friedman, Susan Page, David Ignatius, David Wessel, Mark Halperin, Katty Kay), and one possible surprise guest. The foundation's blog reports:

One meeting that appears in the White House visitor logs that may seem unexpected is a June 9, 2010 meeting with one Keith R. Murdoch. Does the “R” stand for Rupert? In his book The Promise Jonathan Alter revealed that Emanuel kept a back channel open to NewsCorp owner Rupert Murdoch, who’s real name is Keith Rupert Murdoch. I have not yet confirmed whether this is actually Rupert Murdoch, but I will let you know when I do.

Perhaps Emanuel showed Murdoch a copy of Obama's birth certificate.

Finally a Winner in Iraq

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| Fri Oct. 1, 2010 7:57 AM PDT

We might finally have a winner from the March election in Iraq:

Powerful Shiite cleric Muqtada al-Sadr has agreed to support the bid by Iraq's prime minister to retain power, aides said Friday, in a move that could speed an end to the seven-month political impasse and bring dealmaking that may give key concessions to al-Sadr's anti-American bloc.

The decision by al-Sadr would mark a significant boost for Prime Minister Nouri al-Maliki's Shiite-led coalition to secure enough parliament seats to form a new government.

....Al-Sadr's move apparently sets aside past animosity with al-Maliki for a chance to gain a greater voice in a possible new government. Al-Sadr — who has been in self-exile in Iran since 2007 — has denounced al-Maliki's government for its close ties to Washington and a joint security pact that allows U.S. military presence through at least the end of next year.

So we get the same old Maliki government, but with a greater role for Muqtada al-Sadr. I can't say this fills me with hope for Iraq's future, but I suppose it fills me with relief that they're at least going to have a government of some kind. Stay tuned. 

Alberto Contador: Food Poisoning or Performance Enhancement?

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| Fri Oct. 1, 2010 7:53 AM PDT

We don't know for sure whether cyclist Alberto Contador ingested a performance enhancing drug on a rest day during this year's Tour de France, a tour he won for the third time and the second year in a row. Or, better put, we don't know how, exactly, he ingested said substance found in his system that day. I'm not saying he's guilty of doping, but the very fact that traces of substances that aid in performance are time and again found in athletes' bodies always leaves us at the same place, listening to the who-me/never excuses of how whatever was found couldn't possibly have gotten there on purpose. Look over there, puppies!

The affable, striking Contador won hearts and minds this year with his gracious victory, ceding the only stage he could have won to his closest competitor, backslapping his way through the weeks with complements aimed at his rivals, all the while displaying his elegant and effortless way on the bike, there was little not to like about the guy. Besides, with Lance Armstrong not a contender liking Contador wasn't even unpatriotic. Contador was the year's most beloved Spainard next to Iker Casillas (and you just can't beat this, no matter how far, fast, or high you ride).

So now we hear that Contador might have taken a banned substance clenbuterol which helps increase lung capacity, increases metabolism, etc. etc. But, no, he says, it was the cut of meat he had the night before the test, must have been. "It is a clear case of food contamination," he said yesterday, since clenbuterol is sometimes used (illegally) as a food additive for livestock to promote, of course, muscle growth. 

Contador is not the first to blame the meat we eat for a failed drug test. In 1999, Czech tennis player Petr Korda said veal was to blame for his positive test for anabolic steroids. Barry Bonds cried foul on flaxseed oil, cyclist Floyd Landis blamed too much Jack Daniels, and Andre Agassi insisted his assistant spiked his drink with meth. There was the Olympic snowboarder who inhaled pot at a party, and the soccer player who ended up with his girlfriend's STD medicine where it shouldn't be. And yet these are all athletes for whom the body is the temple. Supreme training regimens mean every calorie is accounted for, every action aimed at achieving total perfection and peak performance. And yet we are supposed to buy that they allowed trainers to rub them with a mystery gel without their knowledge, or that they fervently kissed a girl who had too much cocaine on her tongue. There's so much danger out there athletes can barely breath without getting what turns out to be an unfair advantage.

Sure, Contador may be innocent (and anabolic steroids clenbuterol is not) but his accused forefathers leave a shoddy track record with which he must contend. In the steroid-excuse game a cry of food poisoning surprises no one, and neither would the ultimate revelation that another incredible athlete had a little help.