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But even when the perfect liver became available a few days after she was put on the list, doctors could not operate. What made Nataline different from most transplant patients, and what eventually brought her case to the attention of much of the country, was that her survival did not depend on the availability of an organ or her clinicians or even the quality of care she received. It rested on her health insurance company.

Cigna had denied the initial request to cover the costs of the liver transplant. And the insurer persisted in its refusal, claiming that the treatment was “experimental” and unproven, and despite numerous pleas from Nataline’s physicians to the contrary.

But as relatives and friends organized campaigns to draw public attention to Nataline’s plight, the insurance conglomerate found itself embroiled in a public relations nightmare, one that could jeopardize its very existence. The company reversed its decision. But the change came too late. Nataline died just a few hours after Cigna authorized the transplant.

Mr. Potter was the head of corporate communications at two major insurers, first at Humana and then at Cigna. Now Mr. Potter has written a fascinating book that details the methods he and his colleagues used to manipulate public opinion

Mr. Potter goes on to describe the myth-making he did, interspersing descriptions of front groups, paid spies and jiggered studies with a deft retelling of the convoluted (and usually eye-glazing) history of health care insurance policies.

We learn that executives at Cigna worried that Nataline’s situation would only add fire to the growing public discontent with a health care system anchored by private insurance. As the case drew more national attention, the threat of a legislative overhaul that would ban for-profit insurers became real, and Mr. Potter found himself working on the biggest P.R. campaign of his career.

Cigna hired a large international law firm and a P.R. firm already well known to them from previous work aimed at discrediting Michael Moore and his film “Sicko.” Together with Cigna, these outside firms waged a campaign that would eventually include the aggressive placement of articles with friendly “third party” reporters, editors and producers who would “disabuse the media, politicians and the public of the notion that Nataline would have gotten the transplant if she had lived in Canada or France or England or any other developed country.” A “spy” was dispatched to Nataline’s funeral; and when the Sarkisyan family filed a lawsuit against the insurer, a team of lawyers was assigned to keep track of actions and comments by the family’s lawyer.

In the end, however, Nataline’s death proved to be the final straw for Mr. Potter. “It became clearer to me than ever that I was part of an industry that would do whatever it took to perpetuate its extraordinarily profitable existence,” he writes. “I had sold my soul.” He left corporate public relations for good less than six months after her death.

“I don’t mean to imply that all people who work for health insurance companies are greedier or more evil than other Americans,” he writes. “In fact, many of them feel — and justifiably so — that they are helping millions of people get they care they need.” The real problem, he says, lies in the fact that the United States “has entrusted one of the most important societal functions, providing health care, to private health insurance companies.” Therefore, the top executives of these companies become beholden not to the patients they have pledged to cover, but to the shareholders who hold them responsible for the bottom line.

Mr. Stevens said that Web site owners, or publishers, as he calls them, get a small fee for each link, and the transaction is handled entirely over the Web. Publishers can reject certain keywords and links — Mr. Stevens said some balked at a lingerie link — but for the most part the system is on a kind of autopilot. A client pays Mr. Stevens and his colleagues for links, which are then farmed out to Web sites. Payment to publishers is handled via PayPal.

You might expect Mr. Stevens to have a certain amount of contempt for Google, given that he spends his professional life finding ways to subvert it. But through the evening he mentioned a few times that he’s in awe of the company, and the quality of its search engine.

“I think we need to make a distinction between two different kinds of searches — informational and commercial,” he said. “If you search ‘cancer,’ that’s an informational search and on those, Google is amazing. But in commercial searches, Google’s results are really polluted. My own personal experience says that the guy with the biggest S.E.O. budget always ranks the highest.”

To Mr. Stevens, S.E.O. is a game, and if you’re not paying black hats, you are losing to rivals with fewer compunctions.

WHY did Google fail to catch a campaign that had been under way for months? One, no less, that benefited a company that Google had already taken action against three times? And one that relied on a collection of Web sites that were not exactly hiding their spamminess? Mr. Cutts emphasized that there are 200 million domain names and a mere 24,000 employees at Google.

consistent with George's analysis, authorities last week relaxed past regulations that limited the use of the Internet and social media for election campaigning. Political parties and candidates will be allowed to use a broader range of new media platforms, including blogs, micro-blogs, online photo-sharing platforms, social networking sites and electronic media applications used on mobile phones, for election advertising. The loosening, however, only applies for political party-run websites, chat rooms and online discussion forums. Candidates must declare the new media content they intend to use within 12 hours after the start of the election campaign period. George warned in a recent blog entry that the new declaration requirements could open the way for PAP-led defamation suits against new media using opposition politicians. PAP leaders have historically relied on expensive litigation to suppress opposition and media criticism. "The PAP won't subject everyone's postings to legal scrutiny. But if it decides that a particular opposition politician needs to be utterly demolished, you can bet that no tweet of his would be too tiny, no Facebook update too fleeting ... in order a build the case against the individual," George warned in a journalism blog.

While opposition politicians will rely more on new than mainstream media to communicate with voters, they already recognize that the use of social media will not necessarily translate into votes. "[Online support] can give a too rosy a picture and false degree of comfort," said the RP's Jeyaretnam. "People who [interact with] us online are those who are already convinced with our messages anyway."

5. Don't add "fuel to the flame" Mr Singh felt that my complaint to TNP was simply adding "fuel to the flame", leading to more people to prejudge the article. I asked if TNP would now proceed to cover another angle of the story, picking up on the strong reactions online questioning Dr Balakrishnan. Mr Singh said that they would not, as they did not wish to add more "fuel to the flame".

While officials probably still can’t stand TOC’s guts, such sites represent the more rational and reasonable end of the ideological spectrum in cyberspace. TOC, together with Alex Au’s Yawning Bread and some other individual blogs, have been noticeably pushing for more credible online journalism within their extremely limited means. Most importantly, they have shown some commitment to accountability. They operate openly rather than behind cloaks of pseudonymity, they are not above correcting factual errors when these are pointed out to them, and they practice either pre- or post-moderation of comments to keep discussions within certain bounds.

Bloggers will have to understand that the huge and complex machinery of government is not going to transform itself overnight. Indeed, a blogger-friendly media engagement policy is probably easier to implement for a small and discrete Presidential Election campaign office than it would be for any government ministry.

On the government’s part, officials need to be clear that the success of the experiment cannot be measured by how quickly bloggers and their readers are led to the “right” answers or to a “consensus”, but by the inclusiveness and civility of the conversation: as long as more and more people are trying to persuade one another – rather than ignoring or shouting down one another – such engagement between government and alternative media would be strengthening Singapore’s governance and civic life.

What does it mean when we can no longer distinguish between the actions of the left and the right? If that dynamic no longer accurately distinguishes what occurs, why are so many of our policy debates framed in Left/Right terms? In many ways, American society is increasingly less married to this dynamic: Party Affiliation continues to fall, approval of Congress is at record lows, and voter participation hovers at very low rates.

There is some pushback already taking place against the concentration of corporate power: Mainstream corporate media has been increasingly replaced with user created content – YouTube and Blogs are increasingly important to news consumers (especially younger users). Independent voters are an increasingly larger share of the US electorate. And I suspect that much of the pushback against the Elizabeth Warren’s concept of a Financial Consumer Protection Agency plays directly into this Corporate vs. Individual fight. But the battle lines between the two groups have barely been drawn. I expect this fight will define American politics over the next decade.

Mike’s thesis is essentially: Silly skeptics, it’s impossible to OD on homeopathy!

1. “Notice that they never consume their own medicines in large doses? Chemotherapy? Statin drugs? Blood thinners? They wouldn’t dare drink those.

Of course we wouldn’t. Steven Novella rightly points out that, though Mike thinks he’s being clever here, he’s actually demonstrating a lack of understanding for what the 10:23 campaign is about by using a straw man. Mike later issues a challenge for skeptics to drink their favourite medicines while he drinks homeopathy. Since no one will agree to that for the reasons explained above, he can claim some sort of victory — hence his smugness. But no one is saying that drugs aren’t harmful.

The difference between medicine and poison is in the dose. The vitamins and herbs promoted by the CAM industry are just as potentially harmful as any pharmaceutical drug, given enough of it. Would Adams be willing to OD on the vitamins or herbal remedies that he sells?

Even Adams’ favorite panacea, vitamin D, is toxic if you take enough of it (just ask Gary Null). Notice how skeptics don’t consume those either, because that is not the point they’re making.

The point of these demonstrations is that homeopathy has nothing in it, has no measurable physiological effects, and does not do what is advertised on the package.

2. “Homeopathy, you see, isn’t a drug. It’s not a chemical.” Well, he’s got that right. “You know the drugs are kicking in when you start getting worse. Toxicity and conventional medicine go hand in hand.” [emphasis his]

Here I have to wonder if Adams knows any people with diabetes, AIDS, or any other illness that used to mean a death sentence before the significant medical advances of the 20th century that we now take for granted. So far he seems to be a firm believer in the false dichotomy that drugs are bad and natural products are good, regardless of what’s in them or how they’re used (as we know, natural products can have biologically active substances and effectively act as impure drugs – but leave it to Adams not to get bogged down with details). There is nothing to support the assertion that conventional medicine is nothing but toxic symptom-inducers.

3-11. “But homeopathy isn’t a chemical. It’s a resonance. A vibration, or a harmony. It’s the restructuring of water to resonate with the particular energy of a plant or substance. We can get into the physics of it in a subsequent article, but for now it’s easy to recognize that even from a conventional physics point of view, liquid water has tremendous energy, and it’s constantly in motion, not just at the molecular level but also at the level of its subatomic particles and so-called “orbiting electrons” which aren’t even orbiting in the first place. Electrons are vibrations and not physical objects.” [emphasis his]

This is Star Trek-like technobabble – lots of sciency words

if something — anything — has an effect, then that effect is measurable by definition. Either something works or it doesn’t, regardless of mechanism. In any case, I’d like to see the well-documented series of research that conclusively proves this supposed mechanism. Actually, I’d like to see any credible research at all. I know what the answer will be to that: science can’t detect this yet. Well if you agree with that statement, reader, ask yourself this: then how does Adams know? Where did he get this information? Without evidence, he is guessing, and what is that really worth?

13. “But getting back to water and vibrations, which isn’t magic but rather vibrational physics, you can’t overdose on a harmony. If you have one violin playing a note in your room, and you add ten more violins — or a hundred more — it’s all still the same harmony (with all its complex higher frequencies, too). There’s no toxicity to it.” [emphasis his]

Homeopathy has standard dosing regimes (they’re all the same), but there is no “dose” to speak of: the ingredients have usually been diluted out to nothing. But Adams is also saying that homeopathy doesn’t work by dose at all, it works by the properties of “resonance” and “vibration”. Then why any dosing regimen? To maintain the resonance? How is this resonance measured? How long does the “resonance” last? Why does it wear off? Why does he think televisions can inactivate homeopathy? (I think I might know the answer to that last one, as electronic interference is a handy excuse for inefficacy.)

“These skeptics just want to kill themselves… and they wouldn’t mind taking a few of you along with them, too. Hence their promotion of vaccines, pharmaceuticals, chemotherapy and water fluoridation. We’ll title the video, “SKEPTICS COMMIT MASS SUICIDE BY DRINKING PHARMACEUTICALS AS IF THEY WERE KOOL-AID.” Jonestown, anyone?”

“Do you notice the irony here? The only medicines they’re willing to consume in large doses in public are homeopathic remedies! They won’t dare consume large quantities of the medicines they all say YOU should be taking! (The pharma drugs.)” [emphasis his]

what Adams seems to have missed is that the skeptics have no intention of killing themselves, so his bizarre claims that the 10:23 participants are psychopathic, self-loathing, and suicidal makes not even a little bit of sense. Skeptics know they aren’t going to die with these demonstrations, because homeopathy has no active ingredients and no evidence of efficacy.

The inventor of homeopathy himself, Samuel Hahnemann believed that excessive doses of homeopathy could be harmful (see sections 275 and 276 of his Organon). Homeopaths are pros at retconning their own field to fit in with Hahnemann’s original ideas (inventing new mechanisms, such as water memory and resonance, in the face of germ theory). So how does Adams reconcile this claim?

In the old days, mainstream editors could be relied upon to block publication of any photos (of small audiences) that would embarrass the PAP, but netizens are only too eager to publish such pictures. The paradigm has shifted.

A smart response, in my view, would be for the PAP to shift the paradigm again: No more rallies. Don’t create opportunities to be embarrassed. Once such a decision is taken, the subsequent question will naturally be: How else to campaign for votes? Clearly the answer will have to lie with new media. Perhaps a blitz of cool videos, catchy phrases that can be spread by mobile media and other tools which even I myself, not being state of the art in many ways, cannot anticipate. If indeed they took such a decision some time back, they would have spent maybe 18 months conceptualising and putting together such a campaign.

Meanwhile the opposition parties have been stuck in their old ways (the Singapore Democratic party excepted) thinking in terms of market walkabouts and rallies in muddy fields, assuming that there will be little liberalisation of media rules.

In this New York Times’ article, “Teachers Wonder, Why the scorn?“, the writer notes the often scathing comments from counter-demonstrators – “Oh you pathetic teachers, read the online comments and placards of counterdemonstrators. You are glorified baby sitters who leave work at 3 p.m. You deserve minimum wage.” What had begun as an ostensibly ‘economic reform’ targeted at teachers’ unions has gradually transmogrified into a kind of “character attack” to this section of American society – teachers are people who wage violent protests (thanks to borrowed footage from the West Coast) and they are undeserving of their economic benefits, and indeed treat these privileges as ‘rights’. The ‘war’ is waged on multiple fronts, economic, political, social, psychological even — or at least one gets this sort of picture from reading these articles.

as Singaporeans with a uniquely Singaporean work ethic, we may perceive functioning ‘trade unions’ as those institutions in the so-called “West” where they amass lots of membership, then hold the government ‘hostage’ in order to negotiate higher wages and benefits. Think of trade unions in the Singaporean context, and I think of SIA pilots. And of LKY’s various firm and stern comments on those issues. Think of trade unions and I think of strikes in France, in South Korea, when I was younger, and of my mum saying, “How irresponsible!” before flipping the TV channel.

The reason why I think the teachers’ protests should not be seen solely as an issue about trade-unions, and evaluated myopically and naively in terms of whether trade unions are ‘good’ or ‘bad’ is because the protests feature in a larger political context with the billionaire Koch brothers at the helm, financing and directing much of what has transpired in recent weeks. Or at least according to certain articles which I present here.

In this NYT article entitled “Billionaire Brothers’ Money Plays Role in Wisconsin Dispute“, the writer noted that Koch Industries had been “one of the biggest contributors to the election campaign of Gov. Scott Walker of Wisconsin, a Republican who has championed the proposed cuts.” Further, the president of Americans for Prosperity, a nonprofit group financed by the Koch brothers, had reportedly addressed counter-demonstrators last Saturday saying that “the cuts were not only necessary, but they also represented the start of a much-needed nationwide move to slash public-sector union benefits.” and in his own words -“ ‘We are going to bring fiscal sanity back to this great nation’ ”. All this rhetoric would be more convincing to me if they weren’t funded by the same two billionaires who financially enabled Walker’s governorship.

I now refer you to a long piece by Jane Mayer for The New Yorker titled, “Covert Operations: The billionaire brothers who are waging a war against Obama“. According to her, “The Kochs are longtime libertarians who believe in drastically lower personal and corporate taxes, minimal social services for the needy, and much less oversight of industry—especially environmental regulation. These views dovetail with the brothers’ corporate interests.”

Their libertarian modus operandi involves great expenses in lobbying, in political contributions and in setting up think tanks. From 2006-2010, Koch Industries have led energy companies in political contributions; “[i]n the second quarter of 2010, David Koch was the biggest individual contributor to the Republican Governors Association, with a million-dollar donation.” More statistics, or at least those of the non-anonymous donation records, can be found on page 5 of Mayer’s piece.

Naturally, the Democrats also have their billionaire donors, most notably in the form of George Soros. Mayer writes that he has made ‘generous private contributions to various Democratic campaigns, including Obama’s.” Yet what distinguishes him from the Koch brothers here is, as Michael Vachon, his spokesman, argued, ‘that Soros’s giving is transparent, and that “none of his contributions are in the service of his own economic interests.” ‘ Of course, this must be taken with a healthy dose of salt, but I will note here that in Charles Ferguson’s documentary Inside Job, which was about the 2008 financial crisis, George Soros was one of those interviewed who was not portrayed negatively. (My review of it is here.)

Of the Koch brothers’ political investments, what interested me more was the US’ “first libertarian thinktank”, the Cato Institute. Mayer writes, ‘When President Obama, in a 2008 speech, described the science on global warming as “beyond dispute,” the Cato Institute took out a full-page ad in the Times to contradict him. Cato’s resident scholars have relentlessly criticized political attempts to stop global warming as expensive, ineffective, and unnecessary. Ed Crane, the Cato Institute’s founder and president, told [Mayer] that “global-warming theories give the government more control of the economy.” ‘

K Street refers to a major street in Washington, D.C. where major think tanks, lobbyists and advocacy groups are located.

with recent developments as the Citizens United case where corporations are now ‘persons’ and have no caps in political contributions, the Koch brothers are ever better-positioned to take down their perceived big, bad government and carry out their ideological agenda as sketched in Mayer’s piece

with much important news around the world jostling for our attention – earthquake in Japan, Middle East revolutions – the passing of an anti-union bill (which finally happened today, for better or for worse) in an American state is unlikely to make a headline able to compete with natural disasters and revolutions. Then, to quote Wisconsin Governor Scott Walker during that prank call conversation, “Sooner or later the media stops finding it [the teacher protests] interesting.”

What remains more puzzling for me is why the American public seems to buy into the Koch-funded libertarian rhetoric. Mayer writes, ‘ “Income inequality in America is greater than it has been since the nineteen-twenties, and since the seventies the tax rates of the wealthiest have fallen more than those of the middle class. Yet the brothers’ message has evidently resonated with voters: a recent poll found that fifty-five per cent of Americans agreed that Obama is a socialist.” I suppose that not knowing who is funding the political rhetoric makes it easier for the public to imbibe it.