Blogs

A California Hospital Charged $10,000 for a Cholesterol Test

| Fri Aug. 15, 2014 10:34 AM EDT

By now, I assume we all know that hospitals charge widely varying rates for similar procedures. But it's often hard to pinpoint exactly what's going on. Sometimes it's due to the amount of regional competition. Sometimes the procedures in question vary in ways that simple coding schemes don't pick up. Some doctors are better than others. And of course, hospitals inflate their list prices by different amounts.

All that said, be prepared for your jaw to drop:

Researchers studied charges for a variety of tests at 160 to 180 California hospitals in 2011 and found a huge variation in prices. The average charge for a basic metabolic panel, which measures sodium, potassium and glucose levels, among other indicators, was $214. But hospitals charged from $35 to $7,303, depending on the facility. None of the hospitals were identified.

The biggest range involved charges for a lipid panel, a test that measures cholesterol and triglycerides, a type of fat (lipid), in the blood. The average charge was $220, but costs ranged from a minimum of $10 to a maximum of $10,169. Yes, more than $10,000 for a blood test that doctors typically order for older adults, to check their cholesterol levels.

A lipid panel! This is as standardized a procedure as you could ask for. It's fast, highly automated, identical between hospitals, and has no association with the quality of the doctor who ordered the test. You still might see the usual 2:1 or 3:1 difference in prices, but 1000:1?

So what accounts for this? The researchers have no idea. No insurance company will pay $10,000 for a lipid panel, of course, so the only point of pricing it this high is to exploit the occasional poor sap with no health insurance who happens to need his cholesterol checked. Welcome to health care in America. Best in the world, baby.

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Wondering What #NMOS14 Is?

| Thu Aug. 14, 2014 7:08 PM EDT
Jeremiah Parker, 4, stands in front of his mother, Shatara Parker, as they attend a protest Wednesday, Aug. 13, 2014, in Ferguson, Mo.

Starting tonight at 7pm Eastern time, a National Moment of Silence event will be playing out in gatherings big and small across the country. It's headed up by a New York-based activist and social worker who writes online as Feminista Jones and talked to USA Today about the event:

After an activist posted on Twitter that there would be a vigil in downtown Manhattan for Brown, Feminista Jones reached out.

"I wonder why they always have vigils so far removed from the people who are most likely to be affected by police brutality," she wrote back to the poster. "I just know that people in the Bronx and Brooklyn will struggle getting there on Sunday trains." (The correspondence is documented in a Storify.)

Plans for the peaceful assemblies began through that platform, then moved to Facebook. It's an update to activism Jones compares to "phone banking and letter writing — just reaching 90,000 people."

"We're having a national moment of silence — one chord, one silent voice — to honor not only Mike Brown, not only Eric Garner, but all victims of police brutality, especially those who have lost their lives," she said.

The Root, the online black culture and politics mag, is using the #NMOS14 tag to post heartbreaking photos of unarmed black men shot by police over the years, from Amadou Diallo to Kimani Gray to Oscar Grant to far too many others.

To find an #NMOS14 event near you, check out the Twitter hashtag #NMOS14 and this Facebook listing of local groups. 

The Ferguson Shooting and the Science of Race and Guns

| Thu Aug. 14, 2014 2:03 PM EDT
Ferguson, Mo. residents protesting the shooting of Michael Brown retreat after police detonate tear gas cannisters.

On Saturday, a police officer in Ferguson, Missouri gunned down unarmed black teenager Michael Brown. Eyewitnesses say Brown was killed while trying to run away or surrender, but Ferguson police claim that Brown reached for the officer's gun. It will be a long time before all the facts are sorted out, but research suggests that such claims may be rooted in something deeper than the need to explain actions after the fact: Race may literally make people see things that are not there, whether it's a gun or a reach for a gun.

In a 2001 study, participants were shown a picture of a white face or a black face followed immediately by a picture of a weapon or a tool. They were asked to identify the object as quickly as possible. Study participants more often identified weapons correctly after they saw a black face, and more accurately identified tools after seeing an image of a white face. What's more, "they falsely claimed to see a gun more often when the face was black than when it was white," the report's author wrote. He goes on:

Race stereotypes can lead people to claim to see a weapon where there is none. Split-second decisions magnify the bias by limiting people's ability to control responses. Such a bias could have important consequences for decision making by police officers and other authorities interacting with racial minorities. The bias requires no intentional racial animus, occurring even for those who are actively trying to avoid it.

This study has been repeated by several different groups of scientists with the same results. (When participants are primed with female as opposed to male African-American faces, however, they are less likely to assume the object is a gun.)

A 2005 study by University of Colorado neuroscientists bolsters these findings. The scientists measured threat perception and response in the brains of 40 students to targets in a video game, some of whom were carrying pistols while others carried wallets or cellphones. The study authors predicted that because there is a cultural perception that African-Americans are "more threatening," participants' "shoot response" would come more naturally. Indeed that’s how it panned out. The study found that the students shot black targets with guns more quickly than white targets with guns, and took longer to decide not to shoot unarmed blacks than unarmed whites.

We may never know what was going on in the head of the officer who shot Brown—or, for that matter, in the heads of George Zimmerman or Michael Dunn, or many other killers of unarmed African-Americans in disputed situations. But studies like the above suggest that the underlying problems run deep.

Watch President Obama Deliver Remarks About the Violence In Ferguson, Missouri

| Thu Aug. 14, 2014 1:44 PM EDT

 

President Obama just delivered remarks on the deteriorating situation in Ferguson, Missouri, where Wednesday night St. Louis law enforcement officials fired tear gas on peaceful demonstrators protesting the killing of Michael Brown.

Here are his remarks, transcript courtesy of the Washington Post:

I want to address something that’s been in the news over the last couple of days, and that’s the last situation in Ferguson, Missouri. I know that many Americans have been deeply disturbed by the images we’ve seen in the heartland of our country as police have clashed with people protesting, today I’d like us all to take a step back and think about how we’re going to be moving forward.

This morning, I received a thorough update on the situation from Attorney General Eric Holder, who’s been following and been in communication with his team. I’ve already tasked the Department of Justice and the FBI to independently investigate the death of Michael Brown, along with local officials on the ground. The Department of Justice is also consulting with local authorities about ways that they can maintain public safety without restricting the right of peaceful protest and while avoiding unnecessary escalation. I made clear to the attorney general that we should do what is necessary to help determine exactly what happened and to see that justice is done.

I also just spoke with Governor Jay Nixon of Missouri. I expressed my concern over the violent turn that events have taken on the ground, and underscored that now’s the time for all of us to reflect on what’s happened and to find a way to come together going forward. He is going to be traveling to Ferguson. He is a good man and a fine governor, and I’m confident that working together, he’s going to be able to communicate his desire to make sure that justice is done and his desire to make sure that public safety is maintained in an appropriate way.

Of course, it’s important to remember how this started. We lost a young man, Michael Brown, in heartbreaking and tragic circumstances. He was 18 years old, and his family will never hold Michael in their arms again. And when something like this happens, the local authorities, including the police, have a responsibility to be open and transparent about how they are investigating that death and how they are protecting the people in their communities. There is never an excuse for violence against police or for those who would use this tragedy as a cover for vandalism or looting. There’s also no excuse for police to use excessive force against peaceful protests or to throw protesters in jail for lawfully exercising their First Amendment rights. And here in the United States of America, police should not be bullying or arresting journalists who are just trying to do their jobs and report to the American people on what they see on the ground.

Put simply, we all need to hold ourselves to a high standard, particularly those of us in positions of authority. I know that emotions are raw right now in Ferguson and there are certainly passionate differences about what has happened. There are going to be different accounts of how this tragedy occurred. There are going to be differences in terms of what needs to happen going forward. That’s part of our democracy. But let’s remember that we’re all part of one American family. We are united in common values, and that includes belief in equality under the law, basic respect for public order and the right to peaceful public protest, a reverence for the dignity of every single man, woman and child among us, and the need for accountability when it comes to our government.

So now is the time for healing. Now is the time for peace and calm on the streets of Ferguson. Now is the time for an open and transparent process to see that justice is done. And I’ve asked that the attorney general and the U.S. attorney on the scene continue to work with local officials to move that process forward. They will be reporting to me in the coming days about what’s being done to make sure that happens.

Meet the First Woman to Win the "Nobel Prize of Mathematics"

| Thu Aug. 14, 2014 1:29 PM EDT

On Wednesday, Maryam Mirzakhani became the first woman in 78 years to be awarded the prestigious Fields Medal, considered the highest honor in mathematics. She was selected for "stunning advances in the theory of Riemann surfaces and their moduli spaces."

The Fields Medal is awarded every four years by the International Mathematical Union to outstanding mathematicians under 40 who show promise of future achievement. With the announcement of Mirzakhani and this year's other awardees—Arthur Avila, Manjul Bhargava, and Martin Hairer—there now have been 54 male and 1 female medalists.

Many hope Mirzakhani's Fields medal is a sign of change to come. "I will be happy if it encourages young female scientists and mathematicians," she said in a press release. Christiane Rousseau, vice president of the International Mathematics Union, told the Guardian this is "an extraordinary moment" and "a celebration for women," comparable to Marie Curie's barrier-breaking Nobel prizes in physics and chemistry in the early 20th century.

And as Canadian math professor Izabella Laba wrote: "Mirzakhani's selection does exactly nothing to convince me that women are capable of doing mathematical research at the same level as men. I have never had any doubt about that in the first place…What I take from it instead is that we as a society, men and women alike, are becoming better at encouraging and nurturing mathematical talent in women, and more capable of recognizing excellence in women's work."

Mirzakhani's accomplishment is all the more groundbreaking in light of the well-documented disadvantages and biases women face in math and science. According to the National Academy of Sciences, there are no significant biological differences that could explain women's low representation in STEM academic faculty and leadership positions (although that doesn't stop prominent people from making claims otherwise.) Instead, NAS says we can thank bias and academia's "outmoded institutional structures."

For example, in a 2008 Yale study, professors were asked to rate fictional applicants for a lab manager position. When given an application with a male name at the top, professors rated the candidate more competent and hirable than when given an otherwise identical form with a female name. This bias was found in both male and female faculty members.

And that's not all women in STEM fields have to contend with: A July report found that a full 64 percent of women in various scientific fields were sexually harassed while doing fieldwork.

These disadvantages—along with a history of men getting the credit for discoveries and inventions made by women—help explain why only 9 to 16 percent of tenure-track positions in math-intensive fields at the top 100 US universities are held by women. According to the American Mathematical Society, the share of women earning Ph.D.s in math has remained stagnant for decades:

(Additional AMS data used in the above chart found here.)

Mirzakhani, who grew up in Iran before earning her Ph.D. at Harvard and becoming a professor at Stanford, told the Clay Mathematics Institute in 2008 that she did not initially realize her strength in math: "I don't think that everyone should become a mathematician, but I do believe that many students don't give mathematics a real chance. I did poorly in math for a couple of years in middle school; I was just not interested in thinking about it. I can see that without being excited mathematics can look pointless and cold."

White House Tightens Up Arms Shipments to Israel

| Thu Aug. 14, 2014 1:24 PM EDT

The Obama administration has tightened up the process for providing arms to Israel:

White House and State Department officials who were leading U.S. efforts to rein in Israel's military campaign in the Gaza Strip were caught off guard last month when they learned that the Israeli military had been quietly securing supplies of ammunition from the Pentagon without their approval.

Since then the Obama administration has tightened its control on arms transfers to Israel. But Israeli and U.S. officials say that the adroit bureaucratic maneuvering made it plain how little influence the White House and State Department have with the government of Israeli Prime Minister Benjamin Netanyahu —and that both sides know it.

....U.S. officials said Mr. Obama had a particularly combative phone call on Wednesday with Mr. Netanyahu, who they say has pushed the administration aside but wants it to provide Israel with security assurances in exchange for signing onto a long-term deal.

....While Israeli officials have privately told their U.S. counterparts the poor state of relations isn't in Israel's interest long term, they also said they believed Mr. Netanyahu wasn't too worried about the tensions. The reason is that he can rely on the firmness of Israeli support in Congress, even if he doesn't have the White House's full approval for his policies. The prime minister thinks he can simply wait out the current administration, they say.

Well, I'd say the prime minister is probably right. It's not as if Obama has actually done much of substance to put pressure on Israel despite endless provocations from Netanyahu, but it's a very good bet that the next president will do even less. On the Democratic side, Hillary Clinton is the heavy favorite, and she's made it crystal clear that her support for Netanyahu is complete and total. On the Republican side, it doesn't really matter who the nominee is. As long as it's not Rand Paul, Netanyahu can expect unquestioning fealty.

And in the meantime, he can count on the US Congress not really caring that he publicly treats the US president like an errant child. I keep wondering if one day he'll go too far even for Congress, but I've mostly given up. As near as I can tell, there's almost literally nothing he could do that would cause so much as a grumble.

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How Software Turns Low-Wage Work Into Constant Chaos

| Thu Aug. 14, 2014 12:30 PM EDT

I'm glad to see Jodi Kantor of the New York Times write about the way low-wage workers are abused via scheduling software that turns their lives into an endless series of daily emergencies:

Ms. Navarro’s fluctuating hours, combined with her limited resources, had also turned their lives into a chronic crisis over the clock. She rarely learned her schedule more than three days before the start of a workweek, plunging her into urgent logistical puzzles over who would watch the boy....“You’re waiting on your job to control your life,” she said, with the scheduling software used by her employer dictating everything from “how much sleep Gavin will get to what groceries I’ll be able to buy this month.”

Last month, she was scheduled to work until 11 p.m. on Friday, July 4; report again just hours later, at 4 a.m. on Saturday; and start again at 5 a.m. on Sunday. She braced herself to ask her aunt, Karina Rivera, to watch Gavin, hoping she would not explode in annoyance, or worse, refuse.

....Along with virtually every major retail and restaurant chain, Starbucks relies on software that choreographs workers in precise, intricate ballets, using sales patterns and other data to determine which of its 130,000 baristas are needed in its thousands of locations and exactly when....Scheduling is now a powerful tool to bolster profits, allowing businesses to cut labor costs with a few keystrokes. “It’s like magic,” said Charles DeWitt, vice president for business development at Kronos, which supplies the software for Starbucks and many other chains.

I don't know what the answer to this is, but it's yet another way that the lives of low-income workers have become more and more stressful over time. There's just no such thing as regular hours anymore, and for parents of small children this turns their lives into nonstop chaos. Read the whole thing to get a taste of what this means. Working a low-wage job at a national chain isn't what it used to be even a couple of decades ago.

UPDATE: Starbucks has responded in an email from Cliff Burrows, the group president in charge of United States stores, to its workers:

Mr. Burrows told them the company would revise its software to allow more human input from managers into scheduling. It would banish the practice, much loathed by workers, of asking them to “clopen” — close the store late at night and return just a few hours later to reopen. He said all work hours must be posted at least one week in advance, a policy that has been only loosely followed in the past. And the company would try to move workers with more than an hour’s commute to more convenient locations, he said.

Good for Starbucks. This doesn't address every scheduling issue their workers face, but it's a good start. It would be nice if others big chains followed their example.

Sarah Palin Picks Imaginary Fight With Elizabeth Warren, Loses

| Thu Aug. 14, 2014 11:57 AM EDT

Last month at Netroots Nation, Sen. Elizabeth Warren gave a speech outlining what she considers 11 tenets of modern American liberalism. ("We believe in science, and that means that we have a responsibility to protect this Earth...We believe that no one should work full-time and still live in poverty, and that means raising the minimum wage.") You can watch it in full here.

On August 7, Alaska governor-turned reality star Sarah Palin went on her eponymous television channel to offer a conservative rebuttal.

The thing to keep in mind as you watch the following video is that she had three weeks to write these responses. This is not live. This is not a real debate. There is no moderator. Katie Couric and the lamestream media have no hand in this. This is a Sarah Palin joint.

As Robyn Pennacchia points out at Death & Taxes, the real highlight is Palin's word salad in response to Warren's statement that "we believe that fast-food workers deserve a livable wage, and that means that when they take to the picket line, we are proud to fight alongside them."

'We believe?' Wait, I thought fast food joints, hurh. Don’t you guys think that they’re like of the Devil or somethin’ I was. Liberals, you want to send those evil employees who would dare work at a fast food joint then ya just don’t believe in, thought you wanted to, I dunno, send them to Purgatory or somethin’ so they all go VEGAN and, uh, wages and picket lines I dunno they’re not often discussed in Purgatory, are they? I dunno why are you even worried about fast food wages because dha.

You really should watch the whole thing.

Everyone Is Now Officially Banned From Whining About Presidential Vacations. Forever.

| Thu Aug. 14, 2014 10:59 AM EDT

Yes, yes, yes: sign me up as a charter member of the movement to STFU about presidential vacations. Both sides do it. Bush got hit with criticism from Democrats. Obama gets it from Republicans. Clinton got it. Reagan got it. Fine. We're all guilty. Now let's just stop.

No more golf mockery. No more charts showing how many days Bush took off compared to Obama. No more whining about how this week—yes, this very week!—is the worst week ever in history for a vacation because the world is in crisis. You know why? Because there's always a crisis somewhere in the world.

So that's it. Don't argue about it. Just stop. Right now. It is officially the stupidest thing in the world.

20,000 Watched the Last Public Hanging 78 Years Ago

| Thu Aug. 14, 2014 6:00 AM EDT

An estimated 15,000–20,000 people showed up for what would be the last public execution in the United States.

Around 5:20 a.m., August 14, 1936, Rainey Bethea was led to the gallows in Owensboro, Kentucky for robbing, raping and murdering Lischia Edwards, a 70 year old woman. Bethea was black, Edwards was white. He confessed to committing the crimes, but was only charged with the rape. Unlike a murder conviction, which would have carried a maximum sentence of death by electrocution at the state penitentiary, a rape conviction allowed for the convicted to be publicly hanged in the county where the crime occurred.

In this Friday, Aug. 14, 1936 file picture, a large crowd watches as attendants adjust a black hood over Rainey Bethea's head just before his public hanging in Owensboro, Ky. Bethea, a 22-year-old black man convicted of raping a 70-year-old white woman, was the last person killed in a public execution in the United States.  AP
 

The hanging drew national media attention–largely because the Sheriff of Daviess county was a woman. As Sheriff, Florence Shoemaker Thompson would be responsible for actually hanging Bethea (though she wound up not pushing the lever to the gallows' trapdoor). The media circus surrounding the hanging prompted the Kentucky General Assembly to amend the law in 1938, no longer required convicted rapists to be hanged in the county seat where the crime occurred.