Healthcare Articles

The New York had a fascinating article on Hospice medical care for dying patients. It's very much worth your time to read.

The Atlantic had another good article God Help You. You're on Dialysis.

Here's a NY Times Magazine article from 2005 on the value of autopsies, Buried Answers.

Yes, after reading these on Instapaper on a recent flight, I then played some games on the iPad.

Is Sugar Toxic?

Is Sugar Toxic?. "Lustig’s argument, however, is not about the consumption of empty calories — and biochemists have made the same case previously, though not so publicly. It is that sugar has unique characteristics, specifically in the way the human body metabolizes the fructose in it, that may make it singularly harmful, at least if consumed in sufficient quantities."

"The fructose component of sugar and H.F.C.S. is metabolized primarily by the liver, while the glucose from sugar and starches is metabolized by every cell in the body. Consuming sugar (fructose and glucose) means more work for the liver than if you consumed the same number of calories of starch (glucose). And if you take that sugar in liquid form — soda or fruit juices — the fructose and glucose will hit the liver more quickly than if you consume them, say, in an apple (or several apples, to get what researchers would call the equivalent dose of sugar). The speed with which the liver has to do its work will also affect how it metabolizes the fructose and glucose. In animals, or at least in laboratory rats and mice, it’s clear that if the fructose hits the liver in sufficient quantity and with sufficient speed, the liver will convert much of it to fat. This apparently induces a condition known as insulin resistance, which is now considered the fundamental problem in obesity, and the underlying defect in heart disease and in the type of diabetes, type 2, that is common to obese and overweight individuals. It might also be the underlying defect in many cancers."

It's a very good article.

The Real American Exceptionalism

The Real American Exceptionalism "What is this American exceptionalism Republicans so venerate? After interviewing many Republican leaders,  Washington Post Reporter Karen Tumulty concludes it is the belief that America ‘is inherently superior to the world’s other nations’.  It is a widely held belief.  Indeed, most Americans believe our superiority is not only inherent but divinely ordained.  A survey by the Public Religious Research Institute and the Brookings Institution found that 58 percent of Americans agree with the statement, ‘God has granted America a special role in human history.’

Let me make it clear at the outset.  I too believe in American exceptionalism, although I don’t think God has anything to do with it.  But I suspect my perspective will find little favor among Republicans in general and Tea Party members in particular.  For I believe that America is exceptional in the advantages we’ve had over other nations, not what we’ve done with those advantages."

3 Major Issues with the Latest iPhone Tracking “Discovery”

Alex Levinson (who worked on the book iOS Forensic Analysis) describes 3 Major Issues with the Latest iPhone Tracking “Discovery”. "1) Apple is not collecting this data. 2) This hidden file is neither new nor secret. 3) This “discovery” was published months ago."

Restrepo Documentarian Tim Hetherington Confirmed Killed in Libya

Restrepo Documentarian Tim Hetherington Confirmed Killed in Libya "Having survived many dangerous photographic missions in his life, as well as repeated trips to the lethal Restrepo outpost in Afghanistan—now abandoned by U.S. military—where he shot Oscar-nominated doc Restrepo with co-director Sebastian Junger, British photojournalist and Vanity contributor Tim Hetherington, 41, has died during fighting in Misrata between Muammar Gaddafi’s soldiers and Libyan rebels, along with photographer Chris Hondros."

Restrepo is one of the best war films I've ever seen, well worth seeing.

Byliner Launches With A Splash, Aims To Disrupt Long-Form Journalism

Byliner Launches With A Splash, Aims To Disrupt Long-Form Journalism, "Byliner may wind up disrupting the likes of Vanity Fair and the New Yorker more than it disrupts publishing houses. If blogs deconstructed the breaking news element of newspapers and magazines, Byliner is trying to disrupt the investigative cover story."

Goldman Sachs Accused of Misleading Investors

Don't have time to look in more depth but the BBC reports Goldman Sachs Accused of Misleading Investors. "On Wednesday, the Senate subcommittee said it had found 'a variety of troubling and sometimes abusive practices' by banks in 2007 as the credit crisis began.

The report said that Goldman marketed four sets of complex mortgage securities to banks and other investors, but failed to tell them the investments were very risky.

In addition, the report said the bank did not mention that it was itself betting that the investments' value would fall, indicating it sold products to clients it did not believe in backing itself.

Carl Levin, the Democrat who heads the subcommittee, told a press briefing that Goldman had 'exploited' clients."

The Budget Speech

I didn't watch the speech live and am traveling soon so I'll be pretty quiet til next week. Still, Krugman liked The Budget Speech. "Overall, way better than the rumors and trial balloons. I can live with this. And whatever the pundits may say, it was much, much more serious than the Ryan ‘plan’."

"Substance: Much better than many of us feared. Hardly any Bowles-Simpson — yay! The actual plan relies on some discretionary spending cuts, this time including defense — good, although I think too much is being cut from domestic spending. It relies on letting the Bush tax cuts for the rich expire — finally! — plus unspecified reductions in tax expenditures. The main thing, though, is the strengthened role of and target for the Independent Payment Advisory Board. This can sound like hocus-pocus — but it’s not."

An Imbalanced Budget Deal?

Nate Silver explains why it's not such An Imbalanced Budget Deal? "In other words, I estimate that the median member of the House actually wanted to cut the budget a bit more than the deal that was agreed upon — by about $51 billion rather than $38.5 billion."

"But the notion that Democrats were going to get a radically better deal, with Republicans having such a large and conservative majority in the House, is probably unrealistic. It’s also conceivable that they would have gotten a worse one — say $45 or $50 billion in cuts — had Mr. Boehner made a bolder offer initially."

Either way, we need more stimulus to lower unemployment, not spending cuts.

A Word From Those Who

Paul Krugman in A Word From Those Who complains about the news analyses of the Ryan plan.

"People like me don’t say that the Ryan plan is too radical; we say that it’s a fraud. The spending cuts are largely fake, either because they’re just magic asterisks or because they wouldn’t survive politically; the revenue estimates are fake, because they combine huge tax cuts with vague assurances that extra revenue will be found by closing loopholes. There’s no there there — except for big tax cuts for the rich and pain for the poor."

"I like that phrase, conventional wisdom mad libs. Anyway, no, I don’t think the plan goes too far. I think it’s disingenuous and fraudulent. And the reason I think that is that I have actually done the math."

Guantanamo Teen Was Tortured, Asked To Spy On Other Detainees

Guantanamo Teen Was Tortured, Asked To Spy On Other Detainees "Another former victim of U.S. torture, a child kidnapped and sold to the Americans to be exploited for propaganda and intelligence purposes, drifts off into the misty haziness of neglect and forgetfulness that obscures the truths of our time, courtesy of a President and Congress insistent on burying U.S. crimes as deeply out of public consciousness as possible."

Progressives Must Stand up to the President

Cenk Uygur says Progressives Must Stand up to the President. "So, in the end, he got no credit for the original giant cuts, he got no credit for going a billion past the Republican's wildest dreams and he had to give them an extra $5.5 billion to get a deal. But what he doesn't realize is that the shutdown would have been a disaster for the Republicans -- they never wanted that. They were playing him the whole time. When Boehner came back with the deal, he got a rousing ovation from his side, including the Tea Party faction."

"The whole point of the insane, draconian, ridiculous Paul Ryan budget proposal for next year was to move the spectrum all the way to the radical right, so that they can lure Democrats to a false middle, that is in reality the far right. It's time to stop playing nice with Democrats. Good cop-good cop doesn't work. We need a bad cop. We need a strong progressive wing to keep shouting "no deal!" every time the White House wants to concede (which will be every time)."

Climate Change Breaks NASA's Temperature Charts

Climate change breaks NASA's temperature charts "The Arctic is getting so warm in winter that James Hansen had to add a new colour to the standard legend - pink, which is even warmer than dark red:"

This is What Happens When You Extend Unpaid-For Tax Cuts

This is from January 27th but I just ran across it, This is What Happens When You Extend Unpaid-For Tax Cuts. "Yesterday, the Congressional Budget Office (CBO) – Congress' nonpartisan fiscal scorekeeper – released their revised budget and economic outlook for fiscal year (FY) 2011 through FY 2021. The most newsworthy element of the new estimates is this year's revised deficit projection. As most media outlets noted, Uncle Sam's predicted budgetary shortfall for 2011 went from just over $1 trillion to $1.5 trillion. Extension of the unpaid-for Bush tax cuts comprises almost the entire additional shortfall."

The Deal

David Dayen writes The Ugly, the Ugly, and the Ugly: A Look at the 2011 Funding Deal. "Therefore, this deal inked late last night cut $58.5 billion from the level of McCaskill-Sessions. This equals all of the tax advantages that didn’t extend current law, outside of the business expensing provisions, in the December 2010 tax cut deal. The entire stimulus is gone. Incidentally, John Boehner made an additional point – because the cuts to agency appropriations end up setting a new baseline and magnifying over time, the total impact of cuts in this bill is $500 billion over the next decade. This comes at a time of 8.8% unemployment, when many economists believe additional fiscal stimulus is needed to prop up a nascent and still-fragile recovery. But Washington has gone into austerity mode. You had a Democratic President last night touting the “largest annual spending cut in our history,” as if that were something of which to be proud. Yet it’s undeniable that this cut sets the country backwards and puts it on bad footing for the additional bigger spending fights ahead"

Ezra Klein writes 2011 is not 1995 "The substance of this deal is bad. But the way Democrats are selling it makes it much, much worse."

Robert Reich puts it in schoolyard terms, Why the Right-Wing Bullies Will Hold The Nation Hostage Again and Again. "It is impossible to fight bullies merely by saying they’re going too far."

Here are Lessons in Negotiations from Marian Anderson and Eleanor Roosevelt

Mathew Yglesias explains how the Debt Ceiling and Shutdown fights will have different dynamics.

Donald Trump Responds

Donald Trump Responds in the New York Times to an article about his birther ideas. It's stupid and poorly written and therefore pretty funny.

FactCheck says Donald, You're Fired!

Sidney Lumet Died

Here's the NY Times obituary, Sidney Lumet, 86, Director of Modern Film Classics, Dies.

His first film was 12 Angry Men. It's one of my favorite films and it started me on lifelong love of courtroom dramas.

Before the Devil Knows You're Dead was my favorite film of 2007. I know others have seen it on my recommendation and didn't like, but I still do. I liked the out of sequence story telling and the strong performances of profoundly broken characters.

1964's Fail-Safe changed the way I see films. I won't say why (unless you've seen it), but it made every film I've seen since better.

Dog Day Afternoon, Network, Long Day's Journey Into Night and Serpico are just great films that everyone should see.

I know The Verdict is acclaimed but I'm not a huge fan. I think it's the fault of Mamet's script and not Newman or Lumet. Too many plot points happen off camera.

Strip Search was a great film made for HBO in 2004. It aired only once as HBO was too afraid of political fallout. It's about the aftermath of 9/11 and the Patriot Act. It's two cross-cut interrogations, one in the US and one in China. You'll probably feel different toward the two suspects but then you realize the dialog between the two stories is almost identical. It's the kind of thing I'd expect to find in Playhouse 90 or Studio One, which of course is where Lumet got his start. It's hard to find but if you can, it's well worth seeing.

He also wrote one of my favorite books on film, Making Movies. It's only 200 pages but it really explains all the details of each part of how a film gets made and it's entertaining with a lot of stories from his career.

Update: 5 Essential Life Lessons From the Films of Sidney Lumet

The Health Benefits of Coffee vs Tea Infographic

The Health Benefits of Coffee vs Tea Infographic

The barnacles attached to the budget deal

Ezra Klein wrote about The barnacles attached to the budget deal "I’ve been looking for a full list of the policy riders Republicans attached to their spending bill and it turns out OMB Watch has put one together. There’s some very strange stuff in there: One prohibits the government from funding a database of consumer complaints about financial products. Another blocks the government from enforcing clean-water standards in Florida. A third stops the Bureau of Alcohol, Tobacco, Firearms and Explosives from collecting information ‘on multiple sales of rifles or shotguns to the same person.’ For the record, if someone is stocking up on deadly weaponry, that’s the sort of thing I’d like law-enforcement officials to know. But, as Brian Beutler reports, there are really two riders standing between John Boehner, Harry Reid and a deal: one that prohibits the government from funding Planned Parenthood and one that prohibits the EPA from regulating carbon (actually, both go a bit further than that, but those are their main purposes). "

The OMB Watch pdf is 4 pages and is interesting. It's a long list of "prohibit funds for" various things Republicans hate. Things that affect the environment are the longest list but there are other things. "Prohibits transferring detainees from Guantanamo Bay." is apparently in two sequential sections of the bill and in the next one is "Prohibits constructing facilities to house detainees in Guantanamo Bay." so that works well. It's also against job training, "Prohibits funding for competitions for new Job Corps centers."

Apparently they're also against school lunches. "Prohibits funding for carrying out section 19 of the Richard B. Russell National School Lunch Act." which I think is a Farm-to-School program to "improve access to local foods in schools." Now maybe the argument is we can't afford this? but is this so big a deal to bring it up specifically?

Though my favorite (and I know nothing about it) is "Prohibits funds to provide nonrecourse marketing assistance loans to mohair farmers."

Time to Update the Constitution?

A month ago Fareed Zakaria wrote a very interesting essay, Are America's Best Days Behind Us?. "The tragedy is that Washington knows this. For all the partisan polarization there, most Republicans know that we have to invest in some key areas, and most Democrats know that we have to cut entitlement spending. But we have a political system that has become allergic to compromise and practical solutions. This may be our greatest blind spot. At the very moment that our political system has broken down, one hears only encomiums to it, the Constitution and the perfect Republic that it created. Now, as an immigrant, I love the special and, yes, exceptional nature of American democracy. I believe that the Constitution was one of the wonders of the world — in the 18th century. But today we face the reality of a system that has become creaky. We have an Electoral College that no one understands and a Senate that doesn't work, with rules and traditions that allow a single Senator to obstruct democracy without even explaining why. We have a crazy-quilt patchwork of towns, municipalities and states with overlapping authority, bureaucracies and resulting waste. We have a political system geared toward ceaseless fundraising and pandering to the interests of the present with no ability to plan, invest or build for the future. And if one mentions any of this, why, one is being unpatriotic, because we have the perfect system of government, handed down to us by demigods who walked the earth in the late 18th century and who serve as models for us today and forever."

The other day The Economist commented on it, Constitutionally rotten and then again, In defence of the constitution.

Another Edition of What Ezra Klein Said

The Democrats have a plan for controlling health-care costs. Paul Ryan doesn’t.

"At the heart of Ryan’s budget are policies tying the federal government’s contribution to Medicare and Medicaid to the rate of inflation — which is far, far slower than costs in the health-care sector typically grow. He achieves those caps through cost shifting. For Medicaid, the states have to figure out how to save the money, and for Medicare, seniors will now be purchasing their own insurance plans and, in their new role as consumers, have to figure out how to save the money. It won’t work, and because it won’t work, Ryan’s savings will not materialize."

"The Affordable Care Act’s central hope is that Medicare can lead the health-care system to pay for value, cut down on overtreatment, and cut out treatments that simply don’t work. The law develops Accountable Care Organizations, in which Medicare pays one provider to coordinate all of your care successfully, rather than paying many doctors and providers to add to your care no matter the cost or outcome, as is the current practice. It also begins experimenting with bundled payments, in which Medicare pays one lump-sum for all care related to the successful treatment of a condition rather than paying for every piece of care separately. To help these reforms succeed, and to help all doctors make more cost-effective treatment decisions, the law accelerates research on which drugs and treatments are most effective, and creates and funds the Patient-Centered Outcomes Research Institute to disseminate the data.

If those initiatives work, they head over to the Independent Payment Advisory Board (IPAB), which can implement cost-controlling reforms across Medicare without congressional approval — an effort to make continuous reform the default for Medicare, even if Congress is gridlocked or focused on other matters. And if they don’t work, then it’s up to the Center for Medicare and Medicaid Innovation, a funded body that will be continually testing payment and practice reforms, to keep searching and experimenting, and when it hits on successful ideas, handing them to the IPAB to implement throughout the system.

The law also goes after bad and wasted care: It cuts payments to hospitals with high rates of re-admission, as that tends to signal care isn’t being delivered well, or isn’t being follow up on effectively. It cuts payments to hospitals for care related to infections caught in the hospitals. It develops new plans to help Medicare base its purchasing decisions on value, and new programs to help Medicaid move patients with chronic illnesses into systems that rely on the sort of maintenance-based care that’s been shown to successfully lower costs and improve outcomes."

Napoleon

Stanley Kubrick's screenplay for Napoleon is on Google Docs.

Jon Stewart on Glen Beck's Leaving Fox

Jon Stewart did a great Glen Beck homage last night about Beck's parting from Fox News. Great stuff. The video is in four parts, here's the first (I suspect it will progress to the others as you finish).

The Daily Show - Intro - Jon Tells the Truth While Wearing Glasses
Tags: Daily Show Full Episodes,Political Humor & Satire Blog,The Daily Show on Facebook

Radiation Levels Explained: An exposure infographic

A Scientific American guest blog shows Radiation Levels Explained: An exposure infographic.

"There’s been a lot of confusion and concern about radiation in the past few weeks. As part of the Building a Better Explainer project at NYU’s Studio 20, we decided to create a visual explainer of radiation levels, inspired by some recent presentations over at XKCD and Information is Beautiful.

Rather than use a lot of tiny boxes or a logarithmic scale, we placed all the numbers on a vertical linear scale (it’s pretty long, just keep on scrolling down). Our hope was to transform something you can't see, smell, taste or feel into something a bit more tangible."

I like it. I think I'd reorganize the items at the top a little so that say 3000, 3600 and 3650 were all next to each other, but that's minor. The thing I did learn was that "smoking 1.5 packs a day for a year" exposes you to 36,000 micro-sieverts, or 10 times the normal yearly background dose. Cigarettes are radioactive. Huh.

More Economic Healthcare Political Stuff

I don't know whether to believe any of this or not but Karl Smith says Making the Ryan Economic Assumptions Work "I should note that every single one of these projections is utterly possible and indeed internally consistent. Paul Ryan and Heritage are implicitly assuming a repeal of US immigration restrictions."

Mathew Yglesias says Paul Ryan’s Budget Is Justified By Implausible Projections, But Doesn’t Rely On Them. "Ryan’s proposals are all oriented around shares of GDP. On taxes, for example, he proposes cuts in the income tax rates paid by high-income people and then stipulates that total revenue will nonetheless equal the Bush share of GDP via a mysterious middle class tax increase. Similarly, what he does with Medicare is first privatize it, and then stipulate that the private vouchers will grow at the rate of general inflation plus one percent. Under that plan, Medicare spending as a share of GDP shrinks by definition."

"The math of this part of his agenda is totally impeccable. What’s deficient is the public policy and this is where Heritage’s bad math kicks in. After all, why would you enact this crazy agenda? Now in the case of Paul Ryan the answer is pretty clear—he’s an Ayn Rand fanatic who believes that any effort, whether public or private, to help the poor is immoral. But it’s difficult to sell that as a political agenda! So instead his argument is that we should do it for the macroeconomic benefits. What benefits? Well, the benefits the Heritage Foundation is pretending the plan will have."

Ryan's plan is title "Path to Prosperity" but chuck Marr of CBPP says it's that Just for the Wealthy and is a cruel joke. "For the wealthy, Ryan’s proposals are pure gold...But for working families, whose living standards have stagnated in recent decades, Ryan’s plan seems designed to make it harder for them to help their children have a better life." He gives some examples, but also this graph:



Mathew Yglesias points out what to me seems obvious but he has a graph that should be convincing to anyone. Closing The Deficit By Creating Jobs.



Ezra Klein gives Some guidelines for controlling health-care costs