2012 - %3, April

Government-Run Healthcare is More Efficient Than Private Healthcare

| Fri Apr. 27, 2012 5:00 AM EDT

Can the government provide healthcare more efficiently than the private market? There's no simple answer to that, but a couple of recent data points suggest the answer is yes.

First there's Medicare. It's true that long-term Medicare costs remain our most critical budget problem, thanks to aging baby boomers and ever-expanding treatments for chronic illnesses and end-of-life care. But per-capita Medicare spending has been on a long downward trend, and that trend has been so steady and predictable that a recent study suggested that spending growth per beneficiary over the next decade would be close to zero. Earlier this week we got some confirmation of this when the annual Social Security Trustees report was released. Most of the media attention focused on Social Security, whose financial position deteriorated compared to last year thanks to a slowing economy and an aging population. But using the same economic forecasts, the trustees nonetheless projected no deterioration in Medicare's financial picture. Why? "Once you dig into the numbers," says the Washington Post's Sarah Kliff, "the most plausible explanation is a pretty encouraging one: Our health-care system is getting better at delivering the same medicine more efficiently."

And there's more. On Wednesday, Austin Frakt and Aaron Carroll reported on a new study of Medicaid spending by states. Despite years of horror stories about Medicaid bankrupting state budgets, the study found that most of the increase over the past decade has simply been due to inflation and population growth, not the rising cost of medical care. Adjusted for inflation and population, it turns out that Medicaid spending rose by less than 4% between 2002 and 2011. (That's the dotted line in the chart on the right.) Why has Medicaid done so well? The study quotes Vernon Smith, former Medicaid director for Michigan:

When you look at the rate of growth for all the major payers — Medicaid, Medicare, employer-sponsored insurance, National Health Expenditures — what you see is that no other payer has constrained the rate of growth in spending as well as Medicaid has. [] The reason is that no payer has been as motivated to undertake cost containment as state governments.

This is a key insight, and it doesn't apply only to state governments. One of the problems with the employer-centered healthcare model that we adopted accidentally during and after World War II is that it does a pretty good job of hiding costs. Sure, our premiums and copays rise every year, but most of us have very little idea how much our medical insurance really costs. We pay a small portion, and the rest is, from our point of view, effectively free. By contrast, in European countries, which have done a much better job of controlling costs than the U.S., spending comes largely out of tax dollars, which means that legislatures and taxpayers have to face up to the cost of healthcare every year when they pass a budget. The fact that the process is played out in the rough and tumble of the political spotlight gives everyone a strong incentive to hold down spending. After all, rising costs mean rising taxes.

Until the cost of medical care bites, Americans won't put a lot of pressure on the healthcare industry to rein in its prices and administer care more efficiently. Taxpayer-supported national healthcare could help us get there. The relative efficiency of Medicare and Medicaid are bellwethers we should pay attention to.

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"Safe": The Dumbest Critique of Extrajudicial Killing Ever Made

| Fri Apr. 27, 2012 4:40 AM EDT
"If you skirt due process, I will come for you."

Safe
Lionsgate
95 minutes

Trying to decipher the myriad plot twists of Safe is a lot like attempting to eat your own head: You won't be able to do it, and passersby will point and laugh if you try. The new movie is the latest entry into the Jason-Statham-attacking-everything-that-moves subgenre. But unlike most of the other brainless fare to which the actor has lent his considerable thew, this film seems hell-bent on pummeling the audience with confusion.

The premise of Safe is, on its surface, straight and clean: Statham stars as Luke Wright, an ex-NYPD superstar who, on a whim, rescues a precocious 12-year-old Chinese girl he's never met before. Since the child is being chased by Russian mobsters, Triad gangsters, and crooked cops through the mean streets of Brooklyn, Wright's act of spontaneous altruism commences a citywide mad-dash of headshots and roundhouse kicks. The stage appears set for a by-the-numbers, harmless thriller in which we get to sit back and watch Jason Statham kick the shit out of nameless, unsympathetic henchmen.

If only writer-director Boaz Yakin had been content to stick with the formula. Instead, the film devolves into a needlessly complicated and bizarrely recounted story that ties together organized crime, New York politics, the War on Terror, human trafficking, and covert extrajudicial hit-jobs into one long stretch of garbled dialogue. By the time the credits roll, it's exceedingly difficult to remember who blackmailed whom, which criminals were in bed with which government officials, and who exacted revenge upon whom. What it all boils down to is that greedy CIA agents control everything in New York City, from the elite police squads to the mayor's mansion.

Out of his bungled script, Boaz Yakin did manage to set one new standard: He created the shallowest, sloppiest, most incoherent critique of American power that has ever emerged from Statham-based cinema. The final product looks something like what you'd get if you merged The Trials of Henry Kissinger with Tony Scott's Domino.

15 Reasons You Should Donate to Mother Jones

| Fri Apr. 27, 2012 2:00 AM EDT

Hello dear readers! Yes, it's fundraising time, and we encourage you to donate a few dollars to the Mother Jones Investigative Fund to support independent, investigative journalism.

Unlike NPR, we can't hold your commute hostage to our pleas for money. But what we can do is remind you of some compelling reasons to part with a few of your hard-earned bucks. Ready?

1) Because we still do great longform journalism. Like Mac McClelland's undercover exposé into the warehouse wage slaves behind your online purchases.

2) Because half of all our magazine pieces in 2011 had a female byline–way more than most news/political magazines.

 

3) Because our income inequality charts are so good that Occupy Wall Street protestors put them on signs, Stephen Colbert built a segment around them, and Slate said they deserved a Pulitzer.

4) Because our reporters braved tear gas and arrest rather than back off covering the Occupy movement.

5) Because from pig brains to pink slime, we're not afraid to gross you out.

6) Because we were instrumental in bringing the photography of Vivian Maier to light.

 

 

7) Because we explained and reported the heck out of the Trayvon Martin killing

8) Because we stopped the GOP from redefining rape.

9) Because we made an "are you a slut?" flowchart and support a woman's right to choose to knit her congressman a vagina:

10) Because we allow smart celebrities to speak their mind.

Source: motherjones.com via Mother on Pinterest

11) Because you deserve to know about the nukes speeding by your house.

12) Because our yearlong investigation of the FBI's domestic informant program was so good, it's been picked up by all the big papers (though not always with credit).

13) Because remember the whole exploding Ford Pinto thing? Yeah, that was us.

14) Because we pay our interns, and don't pit them against one another in a weekly acid-saber-fight cage match where only the triumphant one is allowed food.

15) Because we'll help you know the difference between Newt and Schrute.


BONUS: Still not sure? Okay, fine: We invented the po' boy...maybe.

 Delicious oyster po' boy.: fdasA delicious oyster po' boy. Joyce Marrero/ShutterstockWe couldn't have done a single one of these stories without your support. We're a nonprofit, and the support of readers is what keeps us alive. If you've appreciated any of these stories, please donate $5 or $10 to the Mother Jones Investigative Fund right now. We've almost reached our goal, and your gift could be the one that gets us all the way there. Plus, next time you see a great story on Mother Jones, you'll know you played an important part in making it happen. Please give today via credit card or PayPal. Thanks!

Sometimes Dumb Science Turns Out to be Pretty Smart

| Fri Apr. 27, 2012 12:12 AM EDT

Members of Congress love to grandstand about allegedly idiotic studies being funded by federal grants. But guess what? It turns out that a lot of this dumb sounding research ends up being pretty useful:

Federally-funded research of dog urine ultimately gave scientists and understanding of the effect of hormones on the human kidney, which in turn has been helpful for diabetes patients. A study called “Acoustic Trauma in the Guinea Pig” resulted in treatment of early hearing loss in infants. And that randy screwworm study? It helped researchers control the population of a deadly parasite that targets cattle costing the government $250,000 but ultimately saving the cattle industry more than $20 billion, according to Cooper’s office.

More here.

Zealots to the Left of Me, Zealots to the Right of Me

| Thu Apr. 26, 2012 6:08 PM EDT

A "self-perpetuating oligarchy" is an organization where the current leadership plays a strong role in picking its successors. Corporations are an example: the board of directors chooses a CEO, who periodically nominates new members to the board, which eventually chooses the next CEO.

But corporations are only weakly self-perpetuating, since boards usually don't have a lot of loyalty to a particular style of management and CEOs usually don't care all that much who takes over after they retire. Beside, CEOs can be fired. A much better example is the Catholic Church: popes appoint cardinals unilaterally, and the College of Cardinals elects a pope when the old one dies. What's more, popes can't be fired and they care a lot about appointing cardinals who are ideologically sympatico. Mark Kleiman, after reading about the Church's recent humiliation of American nuns for being insufficiently anti-sex, comments:

As the characteristic risks of the democratic republic are corruption and demagogy, and the characteristic risks of hereditary rule are incompetent rulers and succession struggles, the characteristic risk of the self-perpetuating oligarchy is gerontocracy.

For most of the history of the Catholic Church, even the well-fed and well-cared-for tended to drop off by around age 70. So gerontocracy wasn’t a big threat. But modern nutrition, sanitation, and medicine have extended the life of the body by more years than they’ve extended the acuity of the mind. John Paul II put in a rule to get rid of aging Cardinals — mostly so he could complete the process of packing the College with members of his own faction — but didn’t apply the rule to himself, and continued to wear the Triple Tiara until he was long past it.

So — from a secularist perspective — here’s wishing a very long life to Pope Benedict XVI. I doubt that his commitment of the Church to the side of reaction and plutocracy around the world — continuing the work of John Paul II — is now reversible. So the faster the whole thing crashes and burns, the better.

It seems like every time I turn around I'm confronted by growing extremism. The Catholic Church is, increasingly, little more than an angry collection of reactionary old men who hate the modern world. The Republican Party is a refuge for bright-eyed true believers intent on tearing down the modern state. The state of Israel, unable to break the grip of its most expansionist zealots, is busily wreaking its own destruction and doing its best to drag us along with them. Large swaths of the Muslim world remain captured by the fever dreams of its most radical factions.

Unfortunately, none of this seems to be crashing and burning. Not yet, anyway. So when does the wave finally crest and start to break?

Or am I just imagining all this because I'm in a bit of a punk mood today?

Big Changes in Ocean Salinity Intensifying Water Cycle

| Thu Apr. 26, 2012 3:56 PM EDT

Surface salinity changes for 1950 to 2000. Red indicates regions becoming saltier, and blue regions becoming fresher: P.J. Durack, et al. 2012. Science. DOI:10.1126/science.1212222

Surface salinity changes from 1950 to 2000. Red shows regions becoming saltier, blue regions becoming fresher:  P.J. Durack, et al. Science. 2012. DOI:10.1126/science.1212222

A paper in Science today finds rapidly changing ocean salinities as a result of a warming atmosphere have intensified the global water cycle (evaporation and precipitation) by an incredible 4 percent between 1950 and 2000. That's twice the rate predicted by models. 

These same models have long forecast that dry areas of Earth will become drier and wet areas wetter in a warming climate—an intensification of the water cycle driven mostly by the capacity of warmer air to hold and redistribute more moisture in the form of water vapor.

satellite image shows the distribution of water vapor over Africa and the Atlantic Ocean on  2 Sept 2010: NASASatellite image shows the distribution of water vapor over Africa and the Atlantic Ocean on 2 Sept 2010: NASA

But the rate of intensification of the global water cycle is happening far faster than imagined: at about 8 percent per degree Celsius of ocean warming since 1950.

At this rate, the authors calculate:

  • The global water cycle will intensify by a whopping 16 percent in a 2°C warmer world
  • The global water cycle will intensify by a frightening 24 percent in a 3°C warmer world

 

A schematic representation of the global water cycle, with the key role of the ocean and surface rainfall and evaporation fluxes expressed: Durack et al. Science. 2012. DOI:10.1126/science.1212222

A schematic representation of the global water cycle, with the key role of the ocean and surface rainfall and evaporation fluxes expressed: Durack et al. Science. 2012. DOI:10.1126/science.1212222 

The changes will not be uniform across the globe, but trend toward increased drying of arid areas and  increased flooding of wet areas.

And the resulting changes in freshwater availability are likely to be far more destabilizing to human societies and ecosystems than warming alone. 

"Changes to the global water cycle and the corresponding redistribution of rainfall will affect food availability, stability, access, and utilization," says lead author Paul Durack at the University of Tasmania and the Lawrence Livermore National Laboratory.

The paper:

  • Paul J. Durack, Susan E. Wijffels and Richard J. Matear. Ocean Salinities Reveal Strong Global Water Cycle Intensification During 1950 to 2000. Science 2012. DOI:10.1126/science.1212222

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Charles Taylor Convicted of War Crimes. Finally!

| Thu Apr. 26, 2012 3:49 PM EDT
Charles Taylor, in custody in 2006

On Thursday, Charles Taylor, the former president of Liberia, became the first head of state convicted of war crimes by an international court since German naval commander Karl Dönitz (Hitler's successor) faced judgment at the Nuremberg trials. Taylor, who cut his teeth in the '80s as an embezzler and a warlord, was convicted by a UN-backed court in The Hague of aiding and abetting war crimes and crimes against humanity. The Liberian government handed him over to UN security officials in March 2006.

The court at The Hague found Taylor guilty of providing weapons and technical support to Revolutionary United Front rebel forces fighting in the brutal civil war in neighboring Sierra Leone between 1991 and 2002. (The rebels paid Taylor in blood diamonds in exchange for his support.) The RUF army gained international notoreity for its child soldiers, sadistic attacks on civilians, and widespread use of torture. Announcing the verdict, presiding judge Richard Lussick called Taylor's support for the RUF fighters "sustained and significant." Taylor will serve out his sentence in a maximum security prison in the United Kingdom.

Taylor's six-year presidency was by marked by a record of repression and the Second Liberian Civil War. Here are some bizarre facts about the busted war criminal.

1. Taylor went to school in the United States. Like other mass murderers and foreign terrorists, Taylor was educated in America. In 1977, he graduated with a degree in economics from Bentley University in Waltham, Massachusetts. While at studying at Bentley, Taylor was also busy fathering a second child and showing off his sports car on campus grounds. Other notable Bentley alumni include Dallas Cowboy Mackenzy Bernadeau and Mike Mangini, the drummer for the prog-metal band Dream Theater. Comedian Jay Leno also attended, but dropped out after his first semester.

"If Paul Ryan Knew What Poverty Was, He Wouldn't Be Giving This Speech"

| Thu Apr. 26, 2012 2:20 PM EDT
Rep. Paul Ryan (R-Wis.)

Rep. Paul Ryan (R-Wis.), chairman of the House budget committee, knew some Catholics were spoiling for a fight with him Thursday when he was scheduled to speak at Georgetown University, a Catholic institution. Nearly 90 faculty members and administrators sent him a letter expressing concerns with his recent comments that his proposed budget, which includes massive spending cuts to programs for the poor but not a single tax increase, was inspired by his Catholic faith.

"I am afraid that Chairman Ryan's budget reflects the values of his favorite philosopher Ayn Rand rather than the gospel of Jesus Christ," said Father Thomas Reese, a fellow at the Woodstock Theological Center at Georgetown, in a press release Tuesday. "Survival of the fittest may be okay for Social Darwinists but not for followers of the gospel of compassion and love."

The complaints seemed to resonate with Ryan. On Thursday, he went on record denouncing Ayn Rand, who believed altruism is evil, brushing off his well-documented obsession with her as a teenage romance. Ryan told the National Review's Robert Costa: "I reject her philosophy. It's an atheist philosophy. It reduces human interactions down to mere contracts and it is antithetical to my worldview. If somebody is going to try to paste a person's view on epistemology to me, then give me Thomas Aquinas. Don't give me Ayn Rand."

China Has the Rare Earths, So That's Where Apple Makes Its iPads

| Thu Apr. 26, 2012 2:06 PM EDT

Why are iPads made in China? Cheap labor is the obvious answer, but labor is such a small part of the iPad's total cost that this probably isn't the real reason. A more compelling argument is that China simply has a far more efficient high-tech manufacturing sector than America does these days. It's China's "flexibility, diligence and industrial skills" that make it so attractive. This is probably most of the answer, but Elizabeth Chamberlain suggests that China's near-monopoly on rare earth elements might play a role too:

Cambridge engineering professor Dr. Tim Coombs guesses that there may be lanthanum in the iPad’s lithium-ion polymer battery, as well as “a range of rare earths to produce the different colours” in the display....Electronics glass is often polished with cerium oxide. According to a Congressional Research Service report, worldwide demand for rare earths was 136,100 tons in 2010, 45-percent of which was for magnets, glass, and polishing.

Why is all this rare earth consumption a problem? China currently controls 95-97% of the world’s supply of rare earths and has repeatedly cut export quotas, sending already-high prices skyrocketing.

....Today, an American electronics company can only be exempt from China’s rare earth export quotas by manufacturing within China. So that’s what most companies, including Apple, are doing. The only other solution is for us to stop consuming so much—an option that people rarely find appealing. Not as appealing as a retina display, at least.

Interesting suggestion. More on rare earths here.

(Via Felix Salmon.)

Marc Andreessen Thinks You're a Patsy

| Thu Apr. 26, 2012 12:49 PM EDT

Felix Salmon pushes back against the canonization of Marc Andreessen in the current issue of Wired:

When you look at Marc the capitalist, rather than at Marc the ideas guy, the hero-worship becomes a bit more difficult....A lot of my own Wired story, last month, can be read as a push back against the IPO culture which Andreessen, almost more than anybody else, has managed to create.

“Silicon Valley is full of venture capitalists who have become dynastically wealthy off the backs of companies that no longer exist,” I wrote in that piece, and Andreessen is Exhibit A if you want to look for such a person. His first company, Netscape, lost the Browser Wars and ended up getting sold to AOL. His second company, Loudcloud, was (to be charitable) too far ahead of its time, so it “pivoted” into something called Opsware; eventually Andreessen managed to sell it off to HP. His third company, Ning, was even less successful, and ended up buried somewhere in Glam Media. None of them exist today in any recognizable form; none of them ever made much money; and none of them even really made it as far as building anything approaching a permanent income stream.

....While Andreessen is very good at making money, then, he’s much less good at creating lasting value for the long-term shareholders of his companies. In his world, buy-and-hold public shareholders are the patsies, the people left holding the bag when the fast money has long since departed. He’s smart; the rest of us are chumps. I guess it makes perfect sense that he’s recruited Larry Summers as a Special Advisor.

During the 90s I worked for a software company that, although modestly successful, never seemed all that successful compared to the dotcom frenzy that surrounded everything we did. Still, I always liked to joke that at least we made more money than Netscape. Which is to say, we made money.

I've got nothing against Andreessen. He's obviously a pretty brilliant guy who saw the potential of the web before most of us. But Wired also gives him credit for cloud computing, which is kind of silly, and for social networking, which is even sillier. And the idea that somehow Andreessen deserves credit for pioneering the idea that software is going to become hyperintelligent in the near future? Crikey. Is there anyone in the past decade who hasn't predicted that at one time or another?

And even the idea of web browsers as replacements for operating systems, which Andreessen can certainly take a lot of credit for, is happening largely because browsers are becoming nearly as big and complex and buggy as the operating systems they're supplanting. All those thin clients we used to talk about are putting on weight. What's more, yet another buzzy new name doesn't change the fact that cloud computing has the same pros and cons that similar technologies have always had, ever since IBM first offered its customers centralized hosting services about a million years ago. As bandwidth and computing power grows, more stuff can be successfully hosted remotely, and from an IT viewpoint this offers huge advantages in terms of control over your user base. For the same reason, of course, the user base often hates it because it takes away their control. If you don't feel like upgrading Microsoft Word whenever Redmond pumps out a new version, you don't have to. But Google Docs? You upgrade when Google tells you to. The war between the competing needs of centralized IT and unruly users hasn't produced a victor yet.

In any case, no matter how much bandwidth and computing power we have in the cloud, there will always be more locally. And apps will almost certainly expand to take advantage of as much bandwidth as technology can provide. So sure, we'll all live in the cloud in the future, but I don't think we'll live completely in the cloud. It's going to be a lot messier than that.