Wednesday, April 08, 2009

CANADA's BELOW ZERO WEATHER BURNS FAT?

Calorie-Burning Fat? Studies Say You Have It
GINA KOLATA

For more than 30 years, scientists have been intrigued by brown fat, a cell that acts like a furnace, consuming calories and generating heat. Rodents, unable to shiver effectively to keep warm, use brown fat instead. So do human infants, who do not shiver very well. But it was generally believed that humans lose brown fat after infancy, no longer needing it once the shivering response kicks in.

That belief, three groups of researchers report, is wrong.

Their papers, appearing Thursday in The New England Journal of Medicine, indicate that nearly every adult has little blobs of brown fat that can burn huge numbers of calories when activated by the cold, as when sitting in a chilly room that is between 61 and 66 degrees.

Thinner people appeared to have more brown fat than heavier people; younger people more than older people; people with lower glucose levels, presumably reflecting higher metabolic rates, had more than those whose metabolisms were more sluggish; and women had more than men. People taking beta blockers for high blood pressure or other medical indications had less active brown fat.

“The thing about brown fat is that it takes a very small amount to burn a lot of energy,” said Dr. C. Ronald Kahn, head of the section on obesity and hormone action at the Joslin Diabetes Center in Boston.

The fat really is brown, researchers say, because it is filled with mitochondria, the tiny energy factories of cells. Mitochondria contain iron, giving the tissue a reddish brown color.

The hope is that scientists may find safe ways to turn on peoples’ brown fat, allowing them to lose weight by burning more calories. But researchers caution that while mice lose weight if they activate brown fat, it is not clear that people would shed pounds — they might unwittingly eat more, for example. The data on global patterns of obesity are not good enough to say whether living in a cold climate makes people thinner.

The best evidence for the effects of brown fat is from earlier studies in mice, said Leslie P. Kozak, a professor of molecular genetics at the Pennington Biomedical Research Center of Louisiana State University.

Recently, Dr. Kozak put mice predisposed to obesity in a cold room, 41 degrees, for a week. The animals activated their brown fat. As a result, they lost 14 percent of their weight, which constituted 47 percent of their body fat, while eating a high-fat diet with two and a half times more calories than they had consumed at room temperature.

“That’s just by going out in the cold, without any drug treatment,” Dr. Kozak said. But, he cautioned, mice, small animals with a comparatively huge surface area, are easily chilled. “Put the mouse in the cold,” he added, “and it becomes a heat producing machine.”

Jan Nedergaard of the University of Stockholm did the opposite of Dr. Kozak. He and Barbara Cannon, also at the University of Stockholm, studied mice that were genetically engineered so their brown fat could not burn calories. The animals became fat.

“Until very recently, we would have said that it is doubtful that differences in brown fat really could contribute to obesity,” Dr. Nedergaard said. Now, he said he had changed his mind, at least for mice.

The key to finding brown fat in humans was PET-CT scans. The PET scans pinpoint areas where cells are actively burning glucose and the CT scans identify it as fat. Because brown fat rapidly burns glucose to produce heat, it lights up in PET scans. In two of the three studies, investigators also studied samples of brown fat that were removed from a few subjects, confirming that the cells had a protein, UCP-1, that is unique to brown fat.

Brown fat in adult humans was in an unexpected place. Infants have it mostly as a sheet of cells covering their backs. Rodents have it mostly between their shoulder blades, just down from the neck. But in adult humans, it showed up in the upper back, on the side of the neck, in the dip between the collarbone and shoulder, and along the spine.

That may be one reason it was missed for so long, Dr. Kahn said.

“There was an interest in looking at humans 20 or 25 years ago with different scanning techniques, but people were always looking between the shoulder blades,” he said. And since there is so little brown fat — just a few grams of tissue — it can be hard to find, Dr. Kahn added.

His study, one of the three published Thursday, involved 1,972 people who had had PET-CT scans for a variety of reasons. The scans showed brown fat in 7.5 percent of the women and 3 percent of the men — an underestimate, Dr. Kahn says, because the people had not activated brown fat by getting cold.

Dr. Kahn and his colleagues also examined surgical samples taken from the necks of two patients. They concluded that what looked like brown fat in their scans was indeed brown fat.

A second study, led by Wouter D. van Marken Lichtenbelt of Maastricht University in the Netherlands, involved 24 healthy young men. Ten were lean, the rest overweight or obese.

The scans showed no brown fat when the men had been in a room that was a comfortable temperature. But after they were in a chilly room for two hours, scans showed brown fat in all but one, an obese man.

A third study, led by Dr. Sven Enerbäck of the University of Goteborg in Sweden, involved five healthy adults. Each had two scans — one after being in a room at a comfortable temperature, the other after being in a chilly room for two hours. The investigators saw brown fat in their chilled subjects. Three participants allowed the researchers to remove some white fat and some brown fat to demonstrate that what looked like brown fat in the scans really was that elusive substance.

The studies, investigators say, should stimulate research on safe ways to activate brown fat. It is known to be activated not only by cold but also by catecholamines, hormones that are part of the fight or flight response. That is why beta blockers, which block catecholamines, can suppress brown fat activation.

Epinephrine, or adrenaline, and ephedra, an herbal supplement containing epinephrine, can stimulate brown fat, said Dr. Rudolph Leibel, co-director of the Naomi Berrie Diabetes Center at the Columbia University Medical Center. But the drugs have too many side effects to be used for weight loss, he said, adding that while caffeine can bolster ephedra’s effects, it is easy to eat your way out of a brown fat effect.

Brown fat, Dr. Leibel said, “fits the fantasy — I eat what I want and burn it off.” That, however, is still a fantasy, he added.

If a drug that stimulates brown fat could be developed, said Dr. Claude Bouchard of the Pennington Biomedical Research Center, it would be the first obesity drug to affect energy expenditure rather than appetite.

Then there is the notion of simply hanging out in a cold room.

“We’re thinking of opening a frosty spa,” Dr. Kozak said jokingly.

ShamWow: But Wait, There's More...

ShamWow: But Wait, There's More...
Crime scene pics document TV pitchman's brutal encounter with hooker
APRIL 8--In what we promise will be the final installment of the ShamWow Chronicles, on the following pages you will find a selection of police evidence photos memorializing the recent bloody battle between TV pitchman Vince Shlomi and a Miami hooker. As you've likely heard, the ShamWow chieftain, 44, paid Sasha Harris $1000 for "straight sex," which was to occur in Shlomi's $750-a-night room at the lavish Setai hotel. But things went sideways when, according to an account Shlomi gave cops, he kissed the 26-year-old Harris, who responded by biting his tongue and not letting go. Shlomi then punched Harris several times until she released his tongue. He then went to the hotel's lobby, where security called cops. A Miami Beach Police Department Crime Scene unit also arrived at the Setai to photograph the aftermath of the February 7 brawl, which left blood on the hotel room's walls, floor, door, phone, bed, and towels. Cops were also dispatched to the Mount Sinai Medical Center to photograph Shlomi and Harris, who were being treated for their injuries (both were handcuffed to hospital beds since they had been arrested for felony battery). Prosecutors subsequently decided not to pursue charges against either combatant.

MASS KILLING IN THE U S A!

98 Shots Fired in New York Rampage
4-3/09
BINGHAMTON, N.Y. (AP) -- The man who gunned down 13 people at an upstate New York immigration center fired 98 shots from two handguns in a little more than a minute, police said Wednesday.
Ballistics reports showed Jiverly Wong fired 87 times from a 9mm Beretta and 11 times from a .45-caliber handgun.
Police said almost all 13 victims died instantly. Four others were wounded but survived. Wong killed himself as police were rushing to the scene. He was found with a satchel containing several full ammunition clips.
Cops: NC Man Kills Woman, Deputy, Dies in Shootout 4-8/09
RALEIGH, N.C. (AP) -- A man killed his girlfriend and later started a shootout in the woods with sheriff's deputies that killed a lawman and left the gunman dead, investigators said Wednesday.
Craven County sheriff's Capt. Joe Heckman said suspect Clarence Douglas Phillips, 43, died at a nearby hospital from gunshot wounds sustained during the shootout in neighboring Lenoir County. He said deputies found Phillips' girlfriend, 49-year-old Cynthia Tillett Knighten, dead in her Craven County home.
Video Shows Fla. Woman Aiming Gun at Son's Head 4-4/09
CASSELBERRY, Fla. (AP) -- A central Florida woman who fatally shot her son then killed herself at a shooting range wrote in suicide notes to her boyfriend that she was trying to save her son.
''I'm so sorry,'' Marie Moore wrote several times. ''I had to send my son to heaven and myself to Hell.''
She signed two of the notes ''Failed Queen.''
Authorities said Wednesday they still had no motive for the murder-suicide that shocked fellow customers and employees at the Shoot Straight range in Casselberry, about 10 miles north of Orlando, on Sunday.
Man Charged With Buying Guns Used in Ind. Ambush 2-29/09
INDIANAPOLIS (AP) -- A 22-year-old man has been charged with buying two guns for a convicted felon who used them to shoot two Indiana police officers.
A federal grand jury indicted Vincent D. Windell of New Albany on Wednesday.
Prosecutors say Windell bought a .45-caliber handgun and a .38-caliber revolver for 37-year-old Robert Datillo of Clarksville in December.
Motive Sought in Deadly Attack at Calif. Retreat 4-7/09
TEMECULA, Calif. (AP) -- Investigators are trying to determine why a 72-year-old man opened fire at a remote Korean Christian retreat, killing a woman and wounding three other people before being disarmed during a struggle with some of his victims, authorities said Wednesday.
Urinating dog triggered argument resulting in 3 officers' deaths 4-4/09
(CNN) -- Three Pittsburgh, Pennsylvania, police officers were shot to death while responding to a 911 call of a domestic argument triggered by a urinating dog, according to a criminal complaint filed in the case.
The officers were the first department fatalities since 1995, according to the department.
Police said following the shootings Saturday that Richard Poplawski, 22, would be charged with three counts of homicide, aggravated assault and other charges. Poplawski, who was shot in the leg during a four-hour standoff with police, was hospitalized at an undisclosed location, police said.
Details of the incident were included in the police complaint seeking an arrest warrant for Poplawski. The complaint says Margaret Poplawski called 911 about 7 a.m. Saturday to report that her son was "giving her a hard time."She told police she awoke to discover that "the dog had urinated on the floor," and awakened her son "to confront him about it."
The two had an argument, and Margaret Poplawski told her son she was calling police to remove him from her home, according to the complaint. When officers Stephen Mayhle and Paul Sciullo III arrived, she opened the door and let them in.
"Mrs. Poplawski reported that as the officers entered approximately 10 feet into the residence, she heard gunshots, turned and saw her son about six feet away with a long rifle in his hands, at which point she fled downstairs after asking him, 'What the hell have you done?'" the complaint said.
5 children found slain in Washington state, police say 4-4/09
Five children found shot to death in a home in Orting, Washington, Saturday
Father apparently killed self later in nearby King County, sheriff's spokesman say
Police believe the children, ages 7 to 16, were killed by their father
Five children were found shot to death in a home near Tacoma, Washington, Saturday afternoon, police said.
Pierce County sheriff's spokesman Ed Troyer told CNN that the children, ages 7 to 16, were killed by their father, who apparently committed suicide later in nearby King County.
The children -- four girls and one boy
Binghamton struggles to understand why gunman killed 13
Police: Gunman 'lying in wait' killed 3 officers
PITTSBURGH (AP) — A gunman wearing a bulletproof vest and "lying in wait" opened fire on officers responding to a domestic disturbance call Saturday, killing three of them and turning a quiet Pittsburgh street into a battlefield, police said.
Police Chief Nate Harper said the motive for the shooting isn't clear, but friends said the gunman recently had been upset about losing his job and feared the Obama administration was poised to ban guns.
Richard Poplawski, 23, met officers at the doorway and shot two of them in the head immediately, Harper said. An officer who tried to help the two also was killed.
Poplawski, armed with an assault rifle and two other guns, then held police at bay for four hours as the fallen officers were left bleeding nearby, their colleagues unable to reach them, according to police and witnesses. More than 100 rounds were fired by the elite police teams and Poplawski, Harper said.
The three slain officers were Eric Kelly, 41, Stephen Mayhle, 29, and Paul Sciullo III, 37. Kelly had been on the force for 14 years, Mayhle and Sciullo for two years each. Another officer, Timothy McManaway, was shot in the hand and a fifth broke his leg on a fence.
Poplawski had gunshot wounds in his legs but was otherwise unharmed because he was wearing a bulletproof vest, Harper said. He was charged with three counts of homicide, aggravated assault and a weapons violation.
The shooting occurred just two weeks after four police officers were fatally shot in Oakland, California, in the deadliest day for U.S. law enforcement since the attacks of Sept. 11, 2001. The officers were the first Pittsburgh city officers to die in the line of duty in 18 years.

Oakland Seeking Answers in Police Killings 3-29/09
Oakland, Calif. — A day after four police officers were shot down in a rampage, the public and city officials struggled to understand how a routine traffic stop turned into one of the bloodiest days for police officers in California history.
“If we had a motive, we’d know why,” said Jeff Thomason, a spokesman for the Oakland Police Department. “And we want to know why.”
Mr. Thomason had no additional details about the investigations into the shootings on Saturday, which ended with the deaths of three officers: Sgt. Mark Dunakin, 40; Sgt. Ervin Romans, 43; and Sgt. Daniel Sakai, 35.
A fourth officer who was wounded in the shootout, John Hege, 41, was declared brain dead just before noon on Sunday at Highland Hospital, Mr. Thomason said. Officer Hege was being kept on life support as a potential organ donor.
Police officials identified the man who shot the four officers as Lovelle Mixon, a 26-year-old parolee. He was fatally shot by other officers.
The shootings, which spanned several hours and two blocks in the city’s east side, were the deadliest in the history of the Oakland police.

10 KILLED in ALABAMA 3-10-09
A 28-year-old man in Alabama killed 10 people, including his own mother, before taking his own life. MARCH 10, 2009
A few days later in Miami, a man shot and killed five people, including his estranged wife and himself.
BLOODY MASS MURDER STEMS FROM DRUG TRADE 3-12/09

A mass murder in a small North Carolina town turned into a modern morality play as facts emerged this week.

Authorities have determined that drug trafficking was behind the slaughter of four members of a Conover family March 12.

The tragedy shows that delving into a dirty, illegal business can have unintended, deadly consequences.

While Brian Tzeo has not been charged with any crime, the Catawba County Sheriff's Office says he admitted his role in a drug-smuggling ring, receiving opium mailed from Thailand. Tzeo wasn't home when authorities say an associate, Chiew Chan Saevang, went to his house to steal opium and killed Tzeo's wife and three children.

Events took another bizarre turn Wednesday. Saevang and his girlfriend, Yer Yang, also an alleged member of the drug ring, crashed their car in Utah during a pursuit and died by murder-suicide, the Washington County, Utah, Sheriff's Office said.

Theirs were the fifth and sixth deaths in this horrific affair. Neighbors of the Tzeo family and members of the area's Southeast Asian immigrant communities expressed shock, both at the crime itself and at the alleged drug connection. Tzeo and his wife came to the United States from Laos in the 1980s.
Suspect in four Alabama slayings found dead
3-16/09
Man suspected of killing four relatives, including estranged wife
Bodies of slain were found Tuesday morning in a northwestern Alabama home
(CNN) -- A man suspected in the shooting deaths of four people, including his estranged wife and daughter, in northwest Alabama was found dead in an apparent suicide, police said.
Kevin Lee Garner's body was found about 200 yards behind his home in Morgan County, Alabama, said Travis Clemmons, chief investigator for the sheriff's office in neighboring Lauderdale County. He was dead of a self-inflicted gunshot wound, Clemmons said.
Garner was a suspect in the deaths of Tammy Garner, 40, his estranged wife; Chelsea Garner, 16, his daughter; Karen Beaty, his sister; and his nephew, who Clemmons identified only as Robert, saying he did not know his last name.
The four were found dead Tuesday morning in a home in Greenhill, Alabama.

CNBC's CRAMER 'a buffoon'

Economist Nouriel Roubini Lashes Out at CNBC Host
TORONTO (AP) -- CNBC's Jim Cramer has another feud on his hands.

Just weeks after ''The Daily Show'' host Jon Stewart took Cramer to task for trying to turn finance reporting into a ''game,'' famous bear economist Nouriel Roubini criticized Cramer on Tuesday for predicting bull markets.

''Cramer is a buffoon,'' said Roubini, a New York University economics professor often called Dr. Doom. ''He was one of those who called six times in a row for this bear market rally to be a bull market rally and he got it wrong. And after all this mess and Jon Stewart he should just shut up because he has no shame.''

Cramer, the host of CNBC's ''Mad Money'' show, recently wrote in a blog that Roubini is ''intoxicated'' with his own ''prescience and vision'' and said Roubini should realize that things are better since the stock market's recent bottom in early March.

The Standard & Poor's 500 index has rallied 17 percent since then.

Roubini said in 2006 that the worst recession in four decades was on its way. He has attracted attention for his gloomy -- and accurate -- predictions of the U.S. financial market meltdown.

Roubini said the latest surge is just another bear market rally following the pattern of other rallies after the government intervened. He expects the market will test the previous low because of worse-than-expected macroeconomic news, disappointing earnings and because banks will fail after the stress tests come out.

''Once people get the reality check, than it's going to get ugly again,'' Roubini said.

Roubini said Cramer should keep quiet.

''He's not a credible analyst. Every time it was a bear market rally he said it was the beginning of a bull and he got it wrong,'' Roubini said in an interview with The Associated Press.

Asked Wednesday if he thinks the market will touch the low again, Cramer said on CNBC: ''We'll we got that guy Nouriel Roubini and he attacked me today, which I regard a great badge of honor. As all my attackers, I always welcome you on ''Mad Money.'' I think we are not going to see that level again.''

Cramer said if the Dow Jones industrial average goes below 7,000 and the S&P hits 650, buyers will come in because there would be a ferocious rally and investors couldn't afford to miss another.

Cramer has previously conceded he made some wrong calls, like most people watching the market. But he went on ''Today'' last October telling people that if they needed money in the next five years, take it out of the stock market. Anyone who heeded that advice saved money, he said.

Roubini said he supports Treasury Secretary Timothy Geithner's plan to remove toxic assets from the banks. Cramer recently wrote that Roubini and Nobel laureate New York Times columnist Paul Krugman are both on ''the nationalization jihad.''

''He keeps insulting me personally and saying a bunch of lies,'' Roubini said. ''He doesn't even know I was supporting it so he says lies.''

Roubini made the comments before appearing with bank analyst Meredith Whitney and Canadian bears Ian Gordon and Eric Sprott at a Toronto event titled ''A Night with the Bears.'' They all correctly predicted the current financial meltdown.

Whitney, among the most bearish of bank analysts, said that some of the 19 banks undergoing government stress tests may not pass.

''I think the big banks will get through and some of the smaller banks may not,'' Whitney said in an interview with The AP.

Gordon, author of The Long Wave Analyst newsletters, told the event's audience of 1,500 that he expects the Dow Jones industrial average to plummet to 1,000 based on the idea that economic events repeat themselves in regular sequence every 60 years or so.

Sprott, a Canadian hedge fund owner, told the predominantly business crowd that systemic risk remains and that investors should buy gold.

Tuesday, April 07, 2009

Digital Health Records Debate

Push for digital health records sparks debate

By Mimi Hall, USA TODAY
WASHINGTON — The blank wall behind the receptionists' desk stands as a symbol of efficiency in Peter Basch's bustling office. A dozen years ago, Basch and his fellow doctors went paperless and ditched the stacks of patients' charts that stood there.
An early entry into the world of electronic medical records, Basch is an enthusiastic supporter. "It allows our staff and physicians to be far more organized," he says. And that means "more focused on the patient."

President Obama wants doctors' offices and hospitals nationwide to follow suit, and the government has set a goal for every American to have an electronic health record by 2014.

Kathleen Sebelius, the White House nominee for Health and Human Services secretary, calls the move to computerization "one of the linchpins" of overhauling the nation's health care system. Obama casts it as a factor in the nation's economic recovery, saying going paperless would "save billions of dollars and thousands of jobs."

Naysayers suggest health information technology (IT), the overall move to computerization, is full of false promise. Digital records can lead to better care and fewer medical mistakes, they say, but the costly transformation could waste money if the doctors and hospitals buy systems that can't be connected to share information.

"We could head for a techno-Katrina," warns Sen. Barbara Mikulski, D-Md., referring to the government's failed efforts to respond to the 2005 hurricane. "I do not want to do that, where we do a dollar dump, and at the end of the day, we have a lot of microchips floating around."

Costs of an upgrade

Studies published in The New England Journal of Medicine show that less than 2% of hospitals use electronic records in all departments and that 17% of doctors have functioning digital systems.

The Obama administration says the government could save $12 billion over 10 years if doctors go digital because electronic systems help reduce duplication of tests, prevent medical errors and prompt doctors to prescribe less-expensive drugs. "We are confident that health IT will significantly bring down the cost of health care and benefit all Americans," says Nick Papas, a Health and Human Services spokesman.

In February, as part of the $800 billion economic stimulus package, Congress approved $19.5 billion to jump-start health care's digital revolution by providing incentives to doctors and hospitals that take Medicare and Medicaid patients — which 90% do. The federal government plans to set up regional centers, staffed by "geek squads," to help offices get their systems up and running, and those who don't take steps to go digital will face graduated penalties beginning in 2015.

Obama tapped Harvard Medical School professor David Blumenthal to oversee progress.

Questions about the effort are being raised by health care experts.

Avalere Health, a research company for government and industry, released a study last month showing that it will cost the average doctor or small medical practice about $124,000 to upgrade to computers over the period that the government incentives are offered, 2011-15. Those incentives, the study said, would add up to $44,000 per office at best.

Blumenthal co-wrote a study in March that raised similar concerns about the investments needed to buy and maintain the systems.

"There's not much reason to believe that this is going to save significant amounts of money," says Jonathan Oberlander, a University of North Carolina School of Medicine professor.

Push for protections

Basch's seven-doctor practice went digital when it was bought by MedStar Health, so the doctors didn't have to pay for the switch. The office then saved money by going from 3½ staffers per doctor to two. Each of the examining rooms has a large computer screen so doctors and patients can look at records together. If a new drug would interact badly with one the patient is already on, the system lets the doctor know.

As part of MedStar, the office is connected to 500-600 area doctors, several hospitals and labs.

Those kinds of connections raise concerns among privacy rights advocates. Strict new protections, including a ban on the sale of personal health information, were included in the stimulus bill. It's too early to tell how well they will be enforced.

Last week, Kaiser Permanente announced it had fired 15 hospital workers for snooping in the electronic health file of Nadya Suleman, the octuplets' mom.

Without proper protections, health IT could end up harming patients, says Ashley Katz of the group Patient Privacy Rights. If patients don't feel certain their records are protected from employers, creditors and marketers, they may not tell their doctors the truth about certain conditions or behaviors, she says. "The more data you have out there, the more good things you can do," Katz says. "But also, the more bad things."

Healthcare, in the U.S., Britain and Canada?

When it comes to healthcare, the U.S., Britain and Canada are hurting
Healthcare in all three countries has the same problem. They just feel it in different places.
By Ezra Klein

April 7, 2009

When asked by the New England Journal of Medicine to detail his healthcare vision during the campaign, John McCain concluded with a rousing denunciation of "new government bureaucracies that will translate into higher taxes, reduced provider payments and long waiting lines."

Long lines come up frequently in the American healthcare discussion, the symbol of all that is to be feared about a government-run system. And it's true that in Canada and Britain, the two countries most often cited in discussions of what nationalized healthcare might mean, some patients report having to wait months for some elective treatments. Sometimes.

But we've got waiting lines too -- along with 50 million uninsured and a system that costs more than twice as much per person as that of any other country. We've just managed to hide our lines through clever statistical gimmickry.

Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us!

Well, sort of. American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves. So although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of those who can't afford care simply won't get it.

When that very same survey also looked at cost problems among residents of different countries, 24% of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn't fill a prescription. And 22% said they didn't get a test or treatment. Those latter numbers are probably artificially small: If you can't afford to see a doctor, you never know that you can't afford the treatment she would recommend. In Britain and Canada, only about 6% of respondents reported that costs had limited their access to care.

Moreover, surveys conducted by the Organization for Economic Cooperation and Development have found that most countries don't have waiting lines or the uninsured. Not Germany or France or Japan or Sweden, all of which have more of a mix of public and private options. But Canada is next door, and Britain speaks our language, so we tend to spend a lot of time comparing our system with these systems and not a lot of time thinking through the full range of options.

In light of the "Health Affairs" data, smugness about our speedy access to care seems a bit peculiar. If someone can't afford care, we record their waiting time as zero. You don't wait for what you can't have. But a more accurate accounting would record that wait as infinite, or it would record when the patient eventually ends up in the emergency room because the original ailment went untreated. Research like this raises a simple question: Would you rather wait four months for a surgery or be unable to get it altogether?



Just last week, House Republicans expressed their preference for the latter. Their long-awaited budget document was admirably specific about changes to Medicare. They call for "a new Medicare program" in which enrollees are given a check "equal to 100% of the Medicare benefit," which they can then take to the private market to purchase their own care.

This proposal has a purpose beyond dismantling a popular government entitlement program. Currently, Medicare does not abide by a budget. It is not run like the Canadian or British healthcare systems. Instead, it pays whatever is deemed "reasonable and necessary." Because of that, costs are shooting through the roof: The Congressional Budget Office estimates that Medicare spending will more than triple by 2050.

The Republican plan gives Medicare a budget. Costs grow only as fast as the check grows. And because the check grows more slowly than health spending does, the program saves money. But this is, in effect, almost precisely the strategy of Britain and Canada: It is the government imposing an arbitrary budget on its healthcare spending.

The difference is that the British and Canadian governments try to apportion that health spending so that the whole population gets care. That can mean, alongside other cost-saving measures, longer waits for services. The Republican budget simply would give individuals a fixed check. That will mean that patients who exceed that sum and don't have money of their own go without needed care.

So Americans will continue to brag that no one waits, and Canadians and Britons will continue to brag that no one goes without. And somewhere, the French and the Germans and the Japanese and the Swiss and many others will wonder why we insist on choosing between such awful extremes.

Ezra Klein is an associate editor at the American Prospect.

Sunday, April 05, 2009

Larger Than Life in London

A. A. GILL writes from LONDON

IT’S invariably the little things, the unconsidered, off the cuff, in passing, unrehearsed things that snag our attention, and seem to be telling of the bigger things. In the case of Barack Obama’s first visit to London and the Group of 20 conference to save the endangered habitat of bankers and real estate salesmen, it was the handshake with the bobby that seemed to be emblematic. In a forest of waving palms, this handshake meant more.

As the president stepped up to 10 Downing Street, he leant over, made eye contact, said something courteous, and shook the hand of the police officer standing guard. There’s always a police officer there; he is a tourist logo in his ridiculous helmet. He tells you that this is London, and the late 19th century. No one has ever shaken the hand of the policeman before, and like everyone else who has his palm touched by Barack Obama, he was visibly transported and briefly forgot himself. He offered the hand to Gordon Brown, the prime minister, who was scuttling behind.

It was ignored. He was left empty-handed. It isn’t that Mr. Brown snubbed the police officer; he just didn’t see him. To a British politician, a police officer is as invisible as the railings.

But the rest of us noticed. Because in this country that still feels the class system like a phantom limb, being overtly kind to servants is the very height of manners, the mark of true nobility. Being nice to the staff is second only to being nice to dogs as a pinnacle of civilization. Remember: a butler’s not just for Christmas. Apparently, the Obamas searched every cupboard and closet in Downing Street to personally thank all the servants for looking after them. That’s classlessly classy.

You often wonder what visiting dignitaries make of your country; American presidents must think that the whole world is in a constant state of riot. Wherever they go, CNN is full of angry banners, burning flags and tear gas. I went and joined the London riot. It was depressingly flabby, and half-hearted. Not so much a demonstration as a queue of arcane special pleading groups, ranging from anarchists for bicycles (who all waited politely at the traffic lights) and one-world vegans. Altogether, they looked like a collective of European street mimes.

A couple of broken windows and teeth, and that was it. The London police have discovered that the best way to neuter demonstrations is not to move everyone on, or disperse troublemakers, but hold them close, cordon them into a diminishing space for hours and hours, as a sort of arbitrary al fresco arrest. The crowd goes from righteous indignation to fury to despair, and ends up pleading. They’re all desperate to go. It’s crowd control by bladder control: effective but probably illegal.

The Obamas were likely also surprised at how black the old white colonial country is. Ethnic diversity is shamelessly and embarrassingly pushed to the front of every publicity shot. Michelle Obama went to a girls school where a gospel song was performed and where she made a surprisingly moving speech. All the world leaders’ wives are herded together in cultural outings of excruciatingly bland probity, but Mrs. Obama rose above it, and seemed to really inspire this group of young girls. It was noticed. The rest of the women grinned and clutched their handbags, apparently wondering when they could get away to Harrods.

The other thing that she rose above was Queen Elizabeth and Prince Philip: Honey, we shrunk the royal family. If ever we needed a totemic image of the merits of a republic over a monarchy, this was it.

Of all the G-20 wives, Carla Bruni, a k a Mrs. Nicolas Sarkozy, was noticeably absent. With her carefully demure wardrobe and the fluttered eyes of a reformed and legitimized mistress, she was too canny to let her herself be compared to those dumpy other halves. It left one dying to see what Jackie O.-type manipulation would go down when the Obamas crossed the Channel for the NATO summit meeting.

The French are never happy coming to London; this is an ancient and comforting enmity. President Nicolas Sarkozy of France plays nicely to our patronizing stereotypes. He is a small man, a Gallic in lifts who can’t hide the puffed-up, tip-toe insecurities of his shortness. Almost as if he wanted the world to think he has Napoleon syndrome, he postured and pouted and made arbitrary demands, and drew lines in the sand.

The truth is that the French have never really got over being dumped at the altar of the “special relationship.” It should have been them. It was after all, the French who gave you the Statue of Liberty and the keys to the Bastille and who think Jerry Lewis is funny. What did the English ever give you? Muffins and a burnt White House.

The Germans, too, might have imagined a tighter partnership. In terms of ancestry, America is a far more German country than an Anglo-Saxon one, and they have the biggest economy in Europe. Chancellor Angela Merkel of Germany and Mr. Sarkozy made a joint statement that they would categorically veto any further bailouts or attempts to spend our way out of debt, and then a mere 24 hours later they were beaming and shaking hands over an extra trillion-dollar binge.

The salutary fact is that when you look at the grinning group photograph, there is only one face you want to see. This conference was about saving the world, but more important for the participants, it was about saving their political lives. Mr. Obama is the only popular politician left in the world. He would win an election in any one of the G-20 countries, and his fellow world leaders will do anything to take home a touch of that reflected popularity.

We may be in the rare position of having an American president who has a deeper mandate among people who could never vote for him than with those who did. For the time being, he has only to offer his hand, and ask politely.

A. A. Gill is a contributing writer for Vanity Fair and The Sunday Times of London.

Saturday, April 04, 2009

NOT WATCHABLE!!!

NOT WATCHABLE!!!

The F-word News Channel (FNC) is just not watchable!

The few times I switch to see what they are up to.
They are most predicable in these slanted non news propaganda.

The few times I switch to FNC is Saturdays when they say they have NEWS reportage only and not the slanted crap of this wackout right wing ranters.

But there is no hope!

Saturday April 4 10:28 pct – I turned in for less than 30 seconds and
Heard the following:

(1) Finish of budget story (old news has been hashed over a lot – nothing newS)
in which they repeated GOP talking points about Obama’s budget predictions being to optimistic!
This from a bunch that double our national debt over the last 8 years!
(2) Teased a story of some people’s opposition to President Obama being invited to NOTRE DAME to speech at commencement!

This is in a weekend while the President is conducting a tour de force in Europe!!

P.S. I liked this week as DAVID LETTERMAN kicked the crap out of the crapper in chief BILL O’REALLY!! Check out UTube.

Friday, April 03, 2009

Hopping on the misinformation band-Wagoner

Hopping on the misinformation band-Wagoner, GM-style

The media failed and they failed hard this week when it came to news that General Motors CEO Rick Wagoner had resigned at the request of the Obama administration. ABC's Diane Sawyer claimed of the resignation: "[S]omebody said it's like The Apprentice, White House-style." We're not sure who Sawyer's "somebody" actually is, though it is worth noting her comments were far from the worst on the subject. Take, for example, Fox News' Andrew Napolitano, who said that the resignation was "an absolute power grab, and it's the road to fascism" and that "this is Mussolini on the Potomac."

Worse still, many in the media falsely described Wagoner's resignation as unprecedented. A Washington Times editorial labeled Wagoner's departure from GM just that way -- as "unprecedented." At no point did the editorial mention that the government had required AIG, Fannie Mae, and Freddie Mac in September 2008 to replace their CEOs as a condition of receiving government funds during the Bush administration. Similarly, the Los Angeles Times and CNN's Lou Dobbs uncritically repeated Sen. John McCain's false claim that the government's Wagoner decision was "unprecedented." Despite the facts to the contrary, MSNBC's Chris Matthews called McCain's assessment "very correct," while Fox News' Steve Doocy actually claimed "the last president who fired a CEO was Putin" and conservative leader Rush Limbaugh said the White House had sought Wagoner's resignation as "payback for the unions."

Media Matters has been taking the "Limbaugh Challenge" for years

Just a few short weeks after Media Matters for America launched The Limbaugh Wire, a special website dedicated to providing hour-by-hour coverage of and commentary on Limbaugh's radio program, the Los Angeles Times printed an op-ed by Andrew Klavan, a contributing editor of the conservative Manhattan Institute's quarterly magazine, City Journal, in which Klavan claimed: "I listen to Limbaugh every chance I get, and I have never heard the man utter a single racist, hateful or stupid word." Klavan then issued to "liberals" what he referred to as "the Limbaugh Challenge," writing: "Listen to the show. Not for five minutes but for several hours: an hour a day for several days. Consider what he has to say -- the real policy material under the jokes and teasing bluster. Do what your intellectual keepers do not want you to do and keep an open mind." Of course, Media Matters has been listening to the entire Rush Limbaugh Show everyday for years and has documented hundreds of examples of Limbaugh spewing outrageous commentary and basic misstatements of fact. Don't have the time (or the patience) to take "the Limbaugh Challenge" yourself? You can always sign up to receive The Limbaugh Wire by email each weekday.

Media fail to reconcile facts in coverage of president's budget

Throughout Obama's presidency (and even before it started), media figures have tried to pin the blame for the current economic situation on Obama by disappearing the Bush administration's role in their reporting of economic issues and repeatedly referencing the "Obama recession" and the "Obama bear market." Nonetheless, a recent Washington Post/ABC News poll indicates that, as ABCNews.com reported: "Part of Obama's advantage in dealing with the economy is that, while blame and anger are in great supply, he escapes both. Eight in 10 Americans blame the situation on banks and other financial institutions for taking on too much risk; as many blame large business corporations for poor management decisions. Seventy-two percent blame consumers for taking on too much debt; 70 percent blame the Bush administration for lack of needed regulation. Just 26 percent, though, blame the Obama administration." Media Matters released a compelling online video this week contrasting the punditry of media figures with the recent poll -- be sure to check it out.

Additionally, numerous media outlets advanced the false notion that it would be unprecedented for congressional Democrats to use the budget reconciliation process to pass major policy initiatives, or failed to challenge conservatives making such claims. On Fox News' Special Report with Bret Baier, correspondent Molly Henneberg falsely claimed that "[r]econciliation was last used in 2001 by Republicans to pass the first Bush tax cuts." After Media Matters and others pointed out that Republicans used reconciliation to pass several of President Bush's major initiatives after 2001, Baier apologized for Henneberg's "error" three days later. The Washington Post also allowed "moderate" Sen. Arlen Specter (R-PA) to criticize the use of the reconciliation process without noting his votes to use it to pass Bush's tax cuts. The Hill ignored the GOP's use of the reconciliation process in forwarding Republicans' complaints that it "was never intended to ram through major legislation."

Because so many media figures and outlets promoted a number of falsehoods about the president's budget plan, Media Matters released a debunking of three major myths repeated in coverage of the proposal, including the false suggestion that Obama's proposal would increase taxes on a large percentage of small businesses and the previously mentioned falsehood about reconciliation. The debunking also noted that media outlets have engaged in a pattern of criticizing Obama for addressing health care in the budget or elsewhere given the size of the current and projected U.S. federal debt without addressing the president's response that health-care reform is essential to the long-term economic and fiscal health of the country.

Important questions: What will they give? What will she wear?

As the president and first lady arrived in Europe for the G-20 economic summit and a meeting with NATO, many in the media were transfixed by trivial matters. Rather than report on the important issues being discussed at the meetings of world leaders, many seemed to be asking the questions: What did they give the queen? What is Michelle wearing?

While Fox News' Sean Hannity declared he was "not so concerned in what gifts wealthy people are giving each other," he nevertheless repeatedly used his show to complain about the iPod the Obamas gave to the queen. Not to be outdone, his Fox colleague Bill O'Reilly claimed giving an iPod to royalty "would have gotten you beheaded in Henry VIII's time."

If you thought controversy over the gift was ridiculous, coverage of the first lady's attire was even worse. On NBC's Today, co-host Meredith Vieira said the "big question" concerning Michelle Obama's visit with the queen is, "will she bare her arms?" The big question? Days later, Vieira joked about a potential "cat fight" and "mud wrestling" between Mrs. Obama and France's Carla Bruni. Not to be outdone in the women's attire department, MSNBC's Chris Matthews gushed over the "summit" between Obama and Bruni, asking weather they'll be "dressed to beat the other." Hannity, doing his best to gin up yet another conspiracy, claimed it was Michelle Obama's "hope" to "get all these great designer clothes and that everyone will report on it and call [her], you know, Jackie Kennedy."

The Fox Nation launches amid more apologies from ... Fox News

This week, Fox News launched The Fox Nation, which, according to the website, was "created for people who believe in the United States of America and its ideals, as expressed in the Constitution, the Declaration of Independence, and the Emancipation Proclamation." The website goes on to describe itself as a place "for those committed to the core principles of tolerance, open debate, civil discourse -- and fair and balanced coverage of the news."

If it sounds too good to be true, that is because it is.

In an entry to FoxNews.com's Fox Forum, Americans for Tax Reform president Grover Norquist wrote that the website "takes no position on issues -- although unlike so many other Web portals, FOX Nation does begin with the presumption that America is a special and unique place, a blessed land to be treasured and defended." As Media Matters noted, however, The Fox Nation recently labeled Rep. Barney Frank (D-MA) and Sen. Chris Dodd (D-CT) a "[d]angerous duo," linking to an Agence France-Presse article that simply reported that Dodd and Frank "promised President Barack Obama on Monday they would work with the White House to enact a sweeping overhaul of US financial regulatory structures by year's end." Nothing in the AFP article in any way characterized Dodd or Frank as "[d]angerous."

Fair and balanced? Hardly.

Indeed, in the same Fox Forum entry, Norquist undermined his own claim that The Fox Nation "takes no position on issues," writing: "That's right, conservatives, libertarians, and other believers in limited government have found a new home -- at FOX Nation."

News of the website came as Fox News offered its third apology in recent weeks for getting a story relating to the Obama administration plain wrong.

Additionally, Media Matters detailed how, during an interview this week between Happening Now co-host Jon Scott and Rep. Paul Ryan (R-WI), Fox News aired "FOXfact[s]" purporting to describe facts about the House Republican budget, when, in fact, all seven of the on-screen "FOXfact[s]" were nearly identical to portions of an op-ed Ryan published in that day's Wall Street Journal. For example, using nearly identical language, Fox News and Ryan's op-ed both characterized President Obama's cap-and-trade proposal as a "scheme." Ryan wrote, "We do these things by rejecting the president's cap-and-trade scheme"; the "FOXfact" stated that the "GOP budget rejects the president's cap-and-trade scheme."

Don't forget, Media Matters previously noted that Scott passed off a GOP press release as Fox News' own research, even reproducing a typo contained in the Republican press release.

CNN's Kurtz has the Kudlow-down on CNBC

Last weekend on CNN's Reliable Sources, host Howard Kurtz discussed CNBC host Larry Kudlow's decision not to run for U.S. Senate in Connecticut. Kudlow announced his decision after Media Matters issued an open letter to CNBC President Mark Hoffman expressing concern over Kudlow's use of airtime to further his potential candidacy. Kurtz cited Media Matters, noting "Larry Kudlow, the CNBC host, was considering a run for the Senate from Connecticut. But with his network being pressed by the liberal advocacy group Media Matters to say whether he was a pundit or a pol, Kudlow made his decision. ... Kudlow also canceled plans this week to speak at a Republican Party fundraiser in Washington, which is a good thing, since he wouldn't be very credible on CNBC if he were openly shilling for one party."

Ann Coulter: April's Fool

Right-wing pundit Ann Coulter, who often accuses progressives of lacking a sense of humor, fell for a fake April Fools' Day article by Car and Driver magazine this week. The phony article claimed that Obama had ordered GM and Chrysler to cease their participation in NASCAR because it is an "unnecessary expenditure." Falling hook, line, and sinker for the joke, Coulter wrote in her April 1 column, "If Obama can tell GM and Chrysler that their participation in NASCAR is an 'unnecessary expenditure,' isn't having public schools force students to follow Muslim rituals, recite Islamic prayers and plan 'jihads' also an 'unnecessary expenditure'?" Car and Driver later clarified that the story was an April Fools' Day joke, and then removed the story from its website. As USA Today reported, "Car and Driver later pulled the fake story (which estimated savings of $250 million between the manufacturers) and apologized for 'going too far' while noting the magazine 'has a proud tradition of irreverent editorial and we amplify that each year with our April Fool's Day joke.' "

BAN THE BREAST PUMP

Ban the Breast Pump
At another time, in another place, they would have been burned at the stake as witches.

In coming weeks, as the news of their heresy spreads, they will undoubtedly roast in the hellfire of mommy-blog vituperation.

“That was my least favorite thing I ever did in my whole life,” Washington writer Hanna Rosin says in a podcast conversation with three pals that accompanies her sure-to-be-controversial new feature, “The Case Against Breast Feeding,” on The Atlantic’s Web site.

She’s talking about pumping breast milk – the grotesque ritual carried out behind closed office doors nationwide by beleaguered working mothers who are fully “committed” (as the lactation consultants put it) to the goal of long-term, exclusive breast-feeding.

“The way your nipples can get stretched,” the others chime in. “… the nipple gets sucked into the plastic thing” … “and it hurts by the way” … “and you measure your success every day by now many ounces you produce.”

Rosin does an excellent imitation of a breast pump machine as the room erupts into laughter. “Who could blame [your husband] for never wanting to sleep with you again?”

“It’s the moment that kind of brings together all the awfulness of being a modern mother,” she says.

Hallelujah, I all but shouted at the computer, desperate to join in the conversation with these newfound sure-to-be best friends.

And then I flinched. And then I ducked, as though I expected the long arm of All That Is Decent to reach out from behind the screen to strike me.

Now, let me just be clear: I am no enemy of breast-feeding. I nursed both my daughters and would not take back that experience for all the world. But I did not breast-feed them exclusively. I had a mother who breast-fed in the mid-’60s despite the disgust of friends and family, and who insisted that my happiness depended on giving them one bottle of formula a day. I was in France, where their doctor started adding fruits and vegetables to their diet at about three or four months. And where it was easy, after a few miserable weeks, to give up on pumping milk, if only because it made me feel like a cow.

Is it at long last possible – on this side of the Atlantic – to suggest that we’ve maybe taken “breast is best” a bit too far? That a mother’s need for some semblance of physical dignity is perhaps a right worth respecting? That supplementing with formula – if it makes for greater happiness (and emotional availability) in the baby’s most important caretaker – isn’t necessarily an act of gross irresponsibility?

Maybe. Maybe we’re even at a point where it’s permissible to insist that the needs of a mother and the needs of her baby, rather than being opposed are, in fact, linked, and that the best way to meet both is to scale down the demands now put on mothers and beef up support for them.

Rosin’s article, based upon a review of the relevant medical literature and some physician interviews, makes the case that the health claims about breast milk have been greatly overstated. There’s contradictory evidence, she writes, on the virtues of breast milk in combating allergies, leukemia, high cholesterol and diabetes. There is evidence that breast-feeding can help prevent diarrhea, and some indications that breast-feeding might hike up a baby’s I.Q. – by a more or less meaningless couple of points. But the cause of this intelligence boost is unclear. Are breast-fed babies very slightly smarter because they’ve been fed breast milk, or because they’ve been snuggled more closely, been cooed over more exclusively, or otherwise enjoyed any other hard-to-identify-or-isolate variables that simply can’t be controlled in the kinds of studies that currently exist and compare breast-fed and bottle-fed babies?

There’s no way to know. After all, you can’t carry out randomized, controlled trials of baby-feeding. You can’t assemble a group of mothers of equivalent levels of education, income and physical and mental health, control for every possible variation in their emotional availability and parenting style, and then instruct half of them to breast-feed their children, while ordering the other half to bottle-feed for the sake of science. Which means, Rosin writes, that there really is no good science on breast-feeding.

I am sure that the American Academy of Pediatrics – which currently recommends six months of exclusive breast feeding and some breast feeding for at least a year – will soon speak up to refute Rosin’s conclusions, and that the Dr. William Sears-inspired attachment parenting crowd will soon assail her in the blogosphere. Whether her science is or is not on track, I cannot judge. But her argument raises questions that I believe are worth asking.

Why have we made such a fetish of breast milk when there’s no evidence to prove whether, as Rosin puts it in the Atlantic video, “what’s key about breast feeding is the milk or the act of breast-feeding”?

Why, as a society, have we privileged the magic elixir of maternal milk over actual maternal contact, denying the vast, vast majority of mothers the kind of extended maternity leave that would make them physically present for their babies?

Why do we keep sticking our heads in the sand, putting all the burdens of our half-changed society on women – their “choices,” their “priorities,” their bodies – instead of figuring out reasonable ways to make our new family lives work?

Why do we, as women, accept all the guilt and pressure about breast-feeding that comes our way instead of standing up for what we need in order, in the broadest possible sense, to nourish and sustain ourselves and our families?

“There’s this funny thing going on where women have worked for a long time. Almost 50 years. There’s been a tremendous change. Children still have to be raised. The equation doesn’t add up and everyone pretends it’s not happening,” Rosin says near the end of the video interview. “So I feel like when that step happens, there’ll sort of be a degree of ownership, that O.K., we have to make all these things happen at once. And formula will enter into that conversation.”

And she adds, “I’m hoping pump companies will just disappear.”

So am I. In fact, I hope that some day, not too long in the future, books on women’s history will feature photos of breast pumps to illustrate what it was like back in the day when mothers were consistently given the shaft. Future generations of female college students will gaze upon the pumps, aghast.

“Did you actually use one of those?” they’ll ask their mothers, in horror.

And the moms, with a shudder, will proudly say no.