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carolinehayter

Some Vials Of COVID-19 Vaccine Contain Extra Doses, Expanding Supply, FDA Says : Corona... - 0 views

www.npr.org/...n-extra-doses-expanding-supply

Science politics us trump culture policy pandemic vaccine

shared by carolinehayter on 17 Dec 20 - No Cached
  • The Food and Drug Administration says that some of the vials of Pfizer-BioNTech COVID-19 vaccine being distributed throughout the U.S. contain extra doses and the agency is encouraging hospitals and clinics to use the additional shots to speed up the nationwide immunization campaign.
  • The agency issued the guidance Wednesday after health care workers reported throwing out the excess vaccine, fearing it would be against the rules to use it. "At this time, given the public health emergency, FDA is advising that it is acceptable to use every full dose obtainable
  • As health care workers prepared for the vaccine's arrival, they expected to receive vials holding five doses. That left many surprised by the overfilled containers.
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  • Inoculations began in the U.S. on Monday with health care workers and the elderly being the first in line to get it.
  • Leading health experts say that even if all goes well, the vaccine will not be available to the general public until the end of March or beginning of April.
  • Permission to use the additional portions means the limited supply could increase by up to 40%, Politico reported.
  • A vaccine developed by Moderna is expected to get emergency use authorization from the FDA as early as this week. Clinical data shows it is nearly as effective as the Pfizer injections.
  • "It's pretty unusual to have a full extra dose or more though — but it does seem to be there!" Erin Fox, a pharmacist at University of Utah who monitors drug shortages, told the news outlet.
  • However, because there are no preservatives in the vaccines, partial doses from separate vials shouldn't be combined.
  • There are conflicting reports about when the U.S. is poised to receive another batch of the medicine from Pfizer.
  • Meanwhile, The New York Times reported that a second allotment of the Pfizer-BioNTech vaccine may not be available to the U.S. until next June, given the combination of short supply and global demand.
  • Dr. Anthony Fauci, the nation's senior official for infectious diseases, told NPR this week that half of all Americans would need to be vaccinated before seeing an impact on the spread of the virus, and that 75% to 85% of the population would need to be vaccinated to create herd immunity. He predicted the U.S. could begin to see early stages of herd immunity by late spring or summer.
Javier E

Studying Recent Human Evolution at the Genetic Level - NYTimes.com - 0 views

www.nytimes.com/...tion-at-the-genetic-level.html

human evolution genetics research

shared by Javier E on 15 Feb 13 - No Cached
  • researchers have identified a mutation in a critical human gene as the source of several distinctive traits that make East Asians different from other races.
  • The traits — thicker hair shafts, more sweat glands, characteristically identified teeth and smaller breasts — are the result of a gene mutation that occurred about 35,000 years ago, the researchers have concluded.
  • When the mice grew up, the researchers found they did indeed have thicker hair shafts, confirming that the changed gene was the cause of East Asians’ thicker hair. But the gene had several other effects, they report in Thursday’s issue of the journal Cell. One was that the mice, to the researchers’ surprise, had extra sweat glands. A Chinese member of the team, Sijia Wang, then tested people in China and discovered that they, too, had more numerous sweat glands, evidently another effect of the gene. Another surprise was that the engineered mice had less breast tissue, meaning that EDAR could be the reason that East Asian women have generally smaller breasts.
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  • But Joshua Akey, a geneticist at the University of Washington in Seattle, said he thought the more likely cause of the gene’s spread among East Asians was sexual selection. Thick hair and small breasts are visible sexual signals which, if preferred by men, could quickly become more common as the carriers had more children.
  • East Asians are sometimes assumed to have evolved in a cold environment because of their narrow nostrils, which conserve heat, and the extra eyelid fat that insulates the eye. But the Broad team calculates that the EDAR variant arose about 35,000 years ago in central China and that the region was then quite warm and humid. Extra sweat glands would have been advantageous to the hunter-gatherers who lived at that time.
  • The finding that the gene has so many effects raises the question of which one was the dominant trigger for natural selection. Dr. Sabeti said the extra sweat glands could have been the feature favored by natural selection, with all the other effects being dragged along in its train.
  • each of the effects of the EDAR variant may have been favored by natural selection at a different time. A series of selections on different traits thus made the variant version so common among East Asians. About 93 percent of Han Chinese carry the variant, as do about 70 percent of people in Japan and Thailand, and 60 to 90 percent of American Indians, a population descended from East Asians.
kaylynfreeman

Studies Begin to Untangle Obesity's Role in Covid-19 - The New York Times - 0 views

www.nytimes.com/...covid-obesity.html

coronavirus pandemic

shared by kaylynfreeman on 29 Sep 20 - No Cached
  • history of diabetes and heart problems. She weighed close to 300 pounds when she caught the coronavirus, which ravaged her lungs and kidneys.
  • As rates of obesity continue to climb in the United States, its role in Covid-19 is a thorny scientific question. A flurry of recent studies has shown that people with extra weight are more susceptible than others to severe bouts of disease. And experiments in animals and human cells have demonstrated how excess fat can disrupt the immune system.
  • Obesity also disproportionately affects people who identify as Black or Latino — groups at much higher risk than others of contracting and dying from Covid-19, in large part because of exposure at their workplaces, limited access to medical care and other inequities tied to systemic racism. And people with extra weight must grapple with persistent stigma about their appearance and health, even from doctors, further imperiling their prognosis.
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  • researchers found that people with obesity who caught the coronavirus were more than twice as likely to end up in the hospital and nearly 50 percent more likely to die of Covid-19. Another study, which has not yet been peer-reviewed, showed that among nearly 17,000 hospitalized Covid-19 patients in the United States, more than 77 percent had excess weight or obesity.
  • Similar links were unmasked during the H1N1 flu pandemic of 2009, when researchers began to notice that infected people with obesity were more likely to wind up in the hospital and to die. Flu vaccines administered in subsequent years performed poorly in individuals with extra weight, who fell ill more often than their peers even after getting their shots
    • kaylynfreeman
      kaylynfreeman on 29 Sep 20
       
      It seems that the flu and the coronavirus are very similar but the only difference is we don't have a vaccine for CV which is why its more serious
  • Large amounts of fat, for instance, can compress the lower parts of the lungs, making it harder for them to expand when people breathe in.
  • When obesity enters the picture, Dr. Beck said, some of the immune cells found in 30-year-old people “look like those of an 80-year-old.”
  • If the immune systems of people with obesity are more prone to pathogen amnesia, then they may need different dosages of a vaccine. Some products might not work at all in people carrying extra weight
  • Ms. Franklin’s case of Covid-19 was more moderate than her sister’s. But she still deteriorated quickly, to the point where she could no longer reach the bathroom without assistance.
criscimagnael

German Utilities Seek Extra Funding as Energy Prices Explode - The New York Times - 0 views

www.nytimes.com/...-utilities-funding-prices.html

shared by criscimagnael on 13 Jan 22 - No Cached
  • As natural gas prices in Europe continue to hit record highs, utility companies in Germany are scrambling to secure millions of euros in extra liquidity to ensure they can meet future contracts.
  • Last week, another leading German utility, Uniper, announced that high energy prices had forced it to seek extra credit worth 10 billion euros ($11.4 billion). Most of the money, €8 billion, came from Uniper’s parent company, Fortum, based in Finland. The rest is from Germany’s state-owned development bank, KfW, and was secured as a backup to mitigate future price swings, the company said.
  • Other German energy companies, including RWE and EnBW, said that they had taken similar steps to ensure they had sufficient credit to weather the volatility in the European energy market, but declined to give details.
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  • They all face the same challenge of needing to hedge their sales of gas and electricity to cover price differences across different markets.
  • In a statement explaining the decision to provide Uniper with extra financing, Fortum said that European gas prices reached “unprecedented levels” in December.
  • In Germany, the price for energy to heat and power homes in November rose more than 101 percent from a year earlier, the country’s official statistics office, Destatis, said.
  • In Britain, the sudden price rise has led to the collapse of several smaller energy suppliers.
  • Global demand for energy jumped last year, after the world economy reawakened from widespread shutdowns aimed at slowing the spread of the coronavirus pandemic. When many economies started up again last spring, the need for natural gas shot up. Natural gas is crucial for generating electricity, running factories and heating homes across the continent.
  • European countries normally stock up on gas in the summer, when prices are relatively cheap, but the pandemic and a cold winter last year drew down levels of stored gas, leading to the wild swings in prices.
  • Prices for natural gas have risen about sixfold, to record levels. The surge means the wholesale price of electricity has reached stratospheric levels, making headlines across Europe as consumers, battered by the pandemic, are now hit by big increases in their home energy bills. Many European countries have tried to buffer the shock to consumers with price caps, subsidies and direct payments.
  • These high costs are also undermining the economics of companies that make fertilizer, steel, glass and other materials that require a lot of electricity.
Javier E

How Insurers Exploited Medicare Advantage for Billions - The New York Times - 0 views

www.nytimes.com/...vantage-fraud-allegations.html

medicare insurance industry fraud cheating overbilling

shared by Javier E on 09 Oct 22 - No Cached
  • The health system Kaiser Permanente called doctors in during lunch and after work and urged them to add additional illnesses to the medical records of patients they hadn’t seen in weeks. Doctors who found enough new diagnoses could earn bottles of Champagne, or a bonus in their paycheck.
  • Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.
  • Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed.
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  • But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.
  • Medicare Advantage, a private-sector alternative to traditional Medicare, was designed by Congress two decades ago to encourage health insurers to find innovative ways to provide better care at lower cost.
  • by next year, more than half of Medicare recipients will be in a private plan.
  • a New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars.
  • The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits.
  • As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve.
  • Eight of the 10 biggest Medicare Advantage insurers — representing more than two-thirds of the market — have submitted inflated bills, according to the federal audits. And four of the five largest players — UnitedHealth, Humana, Elevance and Kaiser — have faced federal lawsuits alleging that efforts to overdiagnose their customers crossed the line into fraud.
  • The government now spends nearly as much on Medicare Advantage’s 29 million beneficiaries as on the Army and Navy combined. It’s enough money that even a small increase in the average patient’s bill adds up: The additional diagnoses led to $12 billion in overpayments in 2020, according to an estimate from the group that advises Medicare on payment policies — enough to cover hearing and vision care for every American over 65.
  • Another estimate, from a former top government health official, suggested the overpayments in 2020 were double that, more than $25 billion.
  • The increased privatization has come as Medicare’s finances have been strained by the aging of baby boomers
  • Medicare Advantage plans can limit patients’ choice of doctors, and sometimes require jumping through more hoops before getting certain types of expensive care.
  • At conferences, companies pitched digital services to analyze insurers’ medical records and suggest additional codes. Such consultants were often paid on commission; the more money the analysis turned up, the more the companies kept.
  • they often have lower premiums or perks like dental benefits — extras that draw beneficiaries to the programs. The more the plans are overpaid by Medicare, the more generous to customers they can afford to be.
  • Many of the fraud lawsuits were initially brought by former employees under a federal whistle-blower law that allows them to get a percentage of any money repaid to the government if their suits prevail. But most have been joined by the Justice Department, a step the government takes only if it believes the fraud allegations have merit. Last year, the department’s civil division listed Medicare Advantage as one of its top areas of fraud recovery.
  • In contrast, regulators overseeing the plans at the Centers for Medicare and Medicaid Services, or C.M.S., have been less aggressive, even as the overpayments have been described in inspector general investigations, academic research, Government Accountability Office studies, MedPAC reports and numerous news articles,
  • Congress gave the agency the power to reduce the insurers’ rates in response to evidence of systematic overbilling, but C.M.S. has never chosen to do so. A regulation proposed in the Trump administration to force the plans to refund the government for more of the incorrect payments has not been finalized four years later. Several top officials have swapped jobs between the industry and the agency.
  • The popularity of Medicare Advantage plans has helped them avoid legislative reforms. The plans have become popular in urban areas, and have been increasingly embraced by Democrats as well as Republicans.
  • “You have a powerful insurance lobby, and their lobbyists have built strong support for this in Congress,”
  • Some critics say the lack of oversight has encouraged the industry to compete over who can most effectively game the system rather than who can provide the best care.
  • But for insurers that already dominate health care for workers, the program is strikingly lucrative: A study from the Kaiser Family Foundation, a research group unaffiliated with the insurer Kaiser, found the companies typically earn twice as much gross profit from their Medicare Advantage plans as from other types of insurance.
  • In theory, if the insurers could do better than traditional Medicare — by better managing patients’ care, or otherwise improving their health — their patients would cost less and the insurers would make more money.
  • But some insurers engaged in strategies — like locating their enrollment offices upstairs, or offering gym memberships — to entice only the healthiest seniors, who would require less care, to join. To deter such tactics, Congress decided to pay more for sicker patients.
  • Almost immediately, companies saw ways to exploit that system. The traditional Medicare program provided no financial incentive to doctors to document every diagnosis, so many records were incomplete
  • Under the new program, insurers began rigorously documenting all of a patient’s health conditions — say depression, or a long-ago stroke — even when they had nothing to do with the patient’s current medical care.
  • “Even when they’re playing the game legally, we are lining the pockets of very wealthy corporations that are not improving patient care,”
  • The insurers also began hiring agencies that sent doctors or nurses to patients’ homes, where they could diagnose them with more diseases.
  • Cigna hired firms to perform similar at-home assessments that generated billions in extra payments, according to a 2017 whistle-blower lawsuit, which was recently joined by the Justice Department. The firms told nurses to document new diagnoses without adjusting medications, treating patients or sending them to a specialist
  • Nurses were told to especially look for patients with a history of diabetes because it was not “curable,” even if the patient now had normal lab findings or had undergone surgery to treat the condition.
  • Adding the code for a single diagnosis could yield a substantial payoff. In a 2020 lawsuit, the government said Anthem instructed programmers to scour patient charts for “revenue-generating” codes. One patient was diagnosed with bipolar disorder, although no other doctor reported the condition, and Anthem received an additional $2,693.27, the lawsuit said. Another patient was said to have been coded for “active lung cancer,” despite no evidence of the disease in other records; Anthem was paid an additional $7,080.74. The case is continuing.
  • The most common allegation against the companies was that they did not correct potentially invalid diagnoses after becoming aware of them. At Anthem, for example, the Justice Department said “thousands” of inaccurate diagnoses were not deleted. According to the lawsuit, a finance executive calculated that eliminating the inaccurate diagnoses would reduce the company’s 2017 earnings from reviewing medical charts by $86 million, or 72 percent.
  • Some of the companies took steps to ensure the extra diagnoses didn’t lead to expensive care. In an October 2021 lawsuit, the Justice Department estimated that Kaiser earned $1 billion between 2009 and 2018 from additional diagnoses, including roughly 100,000 findings of aortic atherosclerosis, or hardening of the arteries. But the plan stopped automatically enrolling those patients in a heart attack prevention program because doctors would be forced to follow up on too many people, the lawsuit said.
  • Kaiser, which both runs a health plan and provides medical care, is often seen as a model system. But its control over providers gave it additional leverage to demand additional diagnoses from the doctors themselves, according to the lawsuit.
  • At meetings with supervisors, he was instructed to find additional conditions worth tens of millions of dollars. “It was an actual agenda item and how could we get this,” Dr. Taylor said.
  • few analysts expect major legislative or regulatory changes to the program.
  • Even before the first lawsuits were filed, regulators and government watchdogs could see the number of profitable diagnoses escalating. But Medicare has done little to tamp down overcharging.
  • Several experts, including Medicare’s advisory commission, have recommended reducing all the plans’ payments.
  • Congress has ordered several rounds of cuts and gave C.M.S. the power to make additional reductions if the plans continued to overbill. The agency has not exercised that power.
  • The agency does periodically audit insurers by looking at a few hundred of their customers’ cases. But insurers are fined for billing mistakes found only in those specific patients. A rule proposed during the Trump administration to extrapolate the fines to the rest of the plan’s customers has not been finalized.
  • Ted Doolittle, who served as a senior official for the agency’s Center for Program Integrity from 2011 to 2014, said officials at Medicare seemed uninterested in confronting the industry over these practices. “It was clear that there was some resistance coming from inside” the agency, he said. “There was foot dragging.”
  • Last year, the inspector general’s office noted that one company “stood out” for collecting 40 percent of all Medicare Advantage’s payments from chart reviews and home assessments despite serving only 22 percent of the program’s beneficiaries. It recommended Medicare pay extra attention to the company, which it did not name, but the enrollment figure matched UnitedHealth’s.
  • “Medicare Advantage overpayments are a political third rail,” said Dr. Richard Gilfillan, a former hospital and insurance executive and a former top regulator at Medicare, in an email. “The big health care plans know it’s wrong, and they know how to fix it, but they’re making too much money to stop. Their C.E.O.s should come to the table with Medicare as they did for the Affordable Care Act, end the coding frenzy, and let providers focus on better care, not more dollars for plans.”
Javier E

Amazon same-day delivery: How the e-commerce giant will destroy local retail. - Slate M... - 0 views

www.slate.com/...ill_destroy_local_retail_.html

amazon retail shopping

shared by Javier E on 13 Jul 12 - No Cached
  • Amazon’s tax capitulation is part of a major shift in the company’s operations. Amazon’s grand strategy has been to set up distribution centers in faraway, low-cost states and then ship stuff to people in more populous, high-cost states. When I order stuff from Amazon, for instance, it gets shipped to California from one of the company’s massive warehouses in Kentucky or Nevada.
  • now Amazon has a new game. Now that it has agreed to collect sales taxes, the company can legally set up warehouses right inside some of the largest metropolitan areas in the nation. Why would it want to do that? Because Amazon’s new goal is to get stuff to you immediately—as soon as a few hours after you hit Buy
  • Same-day delivery has long been the holy grail of Internet retailers, something that dozens of startups have tried and failed to accomplish. (Remember Kozmo.com?) But Amazon is investing billions to make next-day delivery standard, and same-day delivery an option for lots of customers. If it can pull that off, the company will permanently alter how we shop. To put it more bluntly: Physical retailers will be hosed.
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  • In Seattle, New York, and the United Kingdom, the firm has set up automated “lockers” in drug stores and convenience stores. If you order something from Amazon and you work near one of these lockers, the company will offer to drop off your item there. On your way home from work, you can just stop by Rite Aid, punch in a security code, and get your stuff.
  • I’m a frequent Amazon shopper, and over the last few months I’ve noticed a significant improvement in its shipping times. As a subscriber to Amazon’s Prime subscription service, I’m used to getting two-day shipping on most items for free. But on about a third of my purchases, my package arrives after just one day for no extra charge. Sometimes the service is so speedy it seems almost magical. One Friday afternoon last month, I ordered three smoke alarms, and I debated paying extra for shipping so that I could install them over the weekend. The $9 per item that Amazon charges for Saturday delivery seemed too steep, though, so I went with standard two-day service. The next morning, the delivery guy arrived with my smoke detectors. I’d gotten next-day Saturday service for free
  • I suspect that, over the next few years, next-day service will become its default shipping method on most of its items. Meanwhile it will offer same-day service as a cheap upgrade. For $5 extra, you can have that laptop waiting for you when you get home from work. Wouldn’t you take that deal?
  • Order something in the morning and get it later in the day, without doing anything else. Why would you ever shop anywhere else?
qkirkpatrick

European Union Asks Britain to Pay Extra $2.7 Billion - NYTimes.com - 0 views

www.nytimes.com/...n-to-pay-extra-27-billion.html

european union britain economics politics

shared by qkirkpatrick on 24 Oct 14 - No Cached
  • A demand from the European Union for an extra payment worth $2.7 billion would not be welcome news for any European leader. For Prime Minister David Cameron of Britain, the request on Friday
  • The request for the money, which is about 1.7 billion pounds, came after a recalculation of data showed that the British economy performed better in recent years than previously thought.
  • Mr. Cameron has promised that he will renegotiate the terms of British membership in the European Union if he is re-elected next year, and that he will then hold a referendum in 2017 on whether to stay in the bloc.
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  • Within the Conservative Party, which fears that it will lose voters to the U.K. Independence Party, the demand provoked anger.
  • The revision took place after the European Commission, the executive arm of the bloc, reviewed the economic performance of all member states since 1995 and changed its statistics to take into account elements such as the underground economy.
Javier E

Booster Shots: Is It Ethical to Get an Illicit One Now? - The Atlantic - 0 views

www.theatlantic.com/...620048

vaccine booster

shared by Javier E on 16 Sep 21 - No Cached
  • All three of the booster bandits I spoke with told me that they weren’t worried about taking anything from others who need it by boosting “early,” because the country has so many vaccines that it’s regularly throwing doses out. They have a point: While other countries are still struggling to access and distribute vaccines, the U.S. reportedly wasted at least 12.9 million doses just in June, July, and August. Doran said that vaccine waste “makes me sick,” and that “whoever wants them should have them instead of putting them in the trash.”
  • the moral dilemma of booster banditry is more complicated than that. For Arthur Caplan, a bioethics professor at NYU Langone Health, the details of each case matter. “Jumping the line at age 88 is not the same as running in to get a booster at age 33,” he told me. Still, he thinks that in many cases, overabundance really is enough to justify sneaking a booster, and the practice is a personal gamble with your health more than anything else.
  • Caplan’s right: As my colleague Katherine J. Wu has reported, very early data suggest that extra antibody production spurred by extra doses could cut down on infection and transmission, but by how much—and, more important, for how long—isn’t clear.
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  • And while there’s no reason to suspect that a third dose would be particularly unsafe in healthy people, the FDA hasn’t explicitly declared it safe.
  • How exactly you get your booster shot matters too. Say you don’t qualify for an extra shot and one falls into your lap anyway. Taking it isn’t necessarily a moral error as long as you’re truthful, Faith Fletcher, an assistant professor at Baylor College of Medicine’s Center for Medical Ethics and Health Policy, told me. But lying about your health or vaccine status is strictly out, she said, because it undermines the rules and guidelines that public-health officials design “to really maximize the greatest good among the greatest amount of people.”
  • The real moral failure, Fletcher said, is a systemic one: the fact that shots are falling into the laps of the healthy and vaccinated, rather than programs that bring vaccines to essential workers at their jobs, or to Black Americans at barber shops and stylists, or to walk-up and mobile clinics that can reach people who don’t have internet access.
  • When I reached out to Walgreens, CVS, and Rite Aid, representatives from all three pharmacy chains insisted that their stores are following the rules, but acknowledged that they’re relying on customers to tell the truth.
  • Asking patients to do anything more in order to get the vaccine would be a mistake, Jason Schwartz, a vaccine-policy expert at the Yale School of Public Health, told me. “It’s far more important to get folks vaccinated and to take down barriers that could keep folks who want to get vaccinated from getting [their shots], even if it means that some folks may be playing fast and loose with their own eligibility,” he said.
  • ​​lying (overtly or by omission) to get a third dose can mess up the data on how well third shots are performing among the immunocompromised and how well a two-dose regimen is protecting those with healthy immune systems.
  • On an even more basic level, under-the-table boosting could skew data on national vaccination rates, making public-health authorities think more people have gotten their first or second shots than is actually the case. Essentially, getting a third shot before the CDC’s go-ahead can make it harder for health officials to determine when and if everyone else will really need them.
  • You can understand why the booster bandits have done what they’ve done: Getting another shot offers a sense of safety and control, however fleeting. After 18 months of pandemic life, it’s hard to begrudge anyone that. But the rule-breaking and the lying could help keep us all from really getting the virus under control for that much longer.
Javier E

Europe's energy crisis may get a lot worse - 0 views

messaging-custom-newsletters.nytimes.com/...oakv2

energy crisis europe policy politics economics

shared by Javier E on 10 Aug 22 - No Cached
  • It was only at the end of April that Russia cut gas supplies to Poland and Bulgaria, the first two victims of its energy-pressure campaign. But overall gas shipments are at less than one-third the level they were just a year ago. In mid-June, shipments through Nord Stream 1 were cut by 75 percent; in July, they were cut again.
  • “It is wartime,” Tatiana Mitrova, a research fellow at Columbia, told her colleague Jason Bordoff, a former adviser to Barack Obama, on an eye-opening recent episode of the podcast “Columbia Energy Exchange.”
  • I think there’s been a gradual and growing recognition that we are headed into the worst global energy crisis at least since the 1970s and perhaps longer than that.
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  • “This is something that European politicians and consumers didn’t want to admit for quite a long time. It sounds terrible, but that’s the reality. In wartime the economy is mobilized. The decisions are made by the governments, not by the free market. This is the case for Europe this winter,” she said, adding that we may see forced rationing, price controls, the suspension of energy markets and shutdowns of whole industrial sectors. “We are not actually talking about extremely high prices, but we are talking about physical absence of energy resources in certain parts of Europe.”
  • It’s increasingly clear that Vladimir Putin is using gas as a weapon and trying to supply just enough gas to Europe to keep Europe in a perpetual state of panic about its ability to weather the coming winter.
  • Europe has been finding all the supplies that it can, but governments are realizing that’s not going to be sufficient. There are going to have to be efforts taken to curb demand as well and to prepare for the possibility of really severe energy rationing this winter.
  • If things become really severe this winter, I fear that you could see European countries start to look out for themselves rather than one another.
  • I think we could start to see governments saying, “Well, we’re going to restrict exports. We’re going to keep our energy at home.” Everyone starts to just look out for themselves, which I think would be exactly what Putin would hope for.
  • it would be wise to assume that Russia will use every opportunity it can to turn the screws on Europe.
  • I think you would see Russia continue to restrict gas exports and maybe cut them off completely to Europe — and a very cold winter. I think a combination of those two things would mean sky-high energy prices.
  • governments will have to ration energy supplies and decide what’s important.
  • Since Russia invaded Ukraine and maybe until very recently, I’ve had the sense that the European public and the public beyond Europe, as well as policymakers, have been a little bit sleepwalking into a looming crisis.
  • here was some unrealistic optimism about how quickly Europe could do without Russian gas. And we took too long to confront seriously just how bad the numbers would look if the worst came to pass.
  • I think there was continued skepticism that Putin would really cut the gas supply. “It might be declining. It might be a little bit lower,” people thought. “But he’s not really going to shut off the supply.” And I think now everyone’s recognizing that’s a real possibility.
  • Putin has the ability to do a lot of damage to the global economy — and himself, to be sure — if he cuts oil exports as well.
  • There’s no extra oil supply in the world at all, as OPEC Plus reminded everyone by saying: No, we’re not going to be increasing production much, and we can’t even if we wanted to.
  • For all the talk about high gasoline prices and the rhetoric of Putin’s energy price hike, Russia’s oil exports have not fallen very much. If that were to happen — either because the U.S. and Europe forced oil to come off the market to put economic pressure on Putin or because he takes the oil off the market to hurt all of us — oil prices go up enormously.
  • it depends how much he takes off the market. We don’t know exactly. If Russia were to cut its oil exports completely, the prices would just skyrocket — to hundreds of dollars a barrel, I think.
  • That’s because there’s just no extra supply out there today at all. There’s a very little extra supply that the Saudis and the Emiratis can put on the market. And that’s about it. We’ve used the strategic petroleum reserve, and that’s coming to an end in the next several months.
  • We’re heading into a winter where markets might simply not be able to work anymore as the instrument by which you determine supply and demand.
  • if prices just soar to uncontrollable levels, markets are not going to work anymore. You’re going to need governments to step in and decide who gets the scarce energy supplies — how much goes to heating homes, how much goes to industry. There’s going to be a pecking order of different industries, where some industries are deemed more important to the economy than others.
  • a lot of governments in Europe are putting in place those kinds of emergency plans right now.
  • if the worst comes to pass, governments will, by necessity, step in to say: Homes get the natural gas, and parts of industry get dumped. Probably they would set price caps on energy or massively subsidize it. So it’s going to be very painful.
  • Worryingly for the European economy, this may mean that factories that can’t switch fuels will go dormant.
  • Today, before winter comes, gas prices in Europe are around $60 per million British thermal units. That compares to around $7 to $8 here in the United States
  • if the worst comes to pass, the market, as a mechanism, simply won’t work. The market will break. The prices will go too high. There’s just not enough energy for the market to balance at a certain price.
  • don’t forget, the amount of liquid natural gas that Europe is importing today — Asia is competing for those shipments. What happens if the Asia winter is very bad? What happens if China and others are willing to pay very high prices for it?
  • I think we’re in a multiyear potential energy crisis.
  • one thing that hasn’t gotten enough attention and that I worry most about is the impact this is having on emerging markets and the developing economies, because it is an interconnected market. When Europe is competing to buy L.N.G. at very high prices, not to mention Asia, that means if you’re in Pakistan or Bangladesh or lower-income countries, you’re really struggling to afford it. You’re just priced out of the market for natural gas — and coal. Coal is incredibly expensive now,
  • I think that that is a real potential humanitarian crisis, as a ripple effect of what’s happening in Europe right now.
  • right now, the price of gas in Europe is about four times what it was last year. Russia has cut flows to Europe by two-thirds but is earning the same revenue as it did last year. So Putin is not being hurt by the loss of gas exports to Europe. Europe’s being hurt by that.
  • this situation could last for several years.
  • Could the energy crisis bring about a change of heart, in which European countries withdraw some of their support or even begin to pressure Ukraine to negotiate a settlement? Is it possible that could even happen in advance of this winter?
  • you would imagine that, over time, when you don’t see Ukraine on the front page each and every day, eventually people’s attention wanes a bit and at a certain point the economic pain of high energy prices or other economic harms from the conflict reach a point where support may start to fracture a bit.
  • Whether that reaches a point where you start to see the West put pressure on Ukraine to capitulate, I think we’re pretty far away from that now, because everyone recognizes how outrageous and unacceptable Putin’s conduct is.
redavistinnell

Iceland election could propel radical Pirate party into power | World news | The Guardian - 0 views

www.theguardian.com/...adical-pirate-party-into-power

iceland election radical pirate party power world news

shared by redavistinnell on 26 Oct 16 - No Cached
  • Iceland election could propel radical Pirate party into power
  • A party that favours direct democracy, complete government transparency, decriminalising drugs and offering asylum to Edward Snowden could form the next government in Iceland after the country goes to the polls on Saturday.
  • The radical party, founded by activists and hackers four years ago as part of an international anti-copyright movement, captured 5% of the vote in 2013 elections, winning three seats in Iceland’s 63-member parliament, the Althingi.
  • ...9 more annotations...
  • A poll last week put the Pirates, who hang a black pirate flag in their parliamentary office, on nearly 21% of the vote, far short of the 40%-plus it was polling at the height of mass anti-government protests this spring,
  • The party has ruled out any possibility of forming a coalition with either of the current two ruling parties
  • “the parties forming a government … hiding behind compromises in coalition – enabling them to cheat voters again and again”.
  • nce the 2008 crash when Iceland’s three biggest banks collapsed owing 11 times the country’s GDP, Reykjavík’s stock market fell 97% and the value of the krona halved, Iceland has recovered economically.
  • Support for the Independence party, the Pirates’ rival for the position of largest party, seems to be holding.
  • Birgitta Jónsdóttir, the Pirates’ parliamentary leader, has said her party is willing to form a government with any party that subscribes to its agenda of “fundamental system change”, including the introduction of a new, crowdsourced national constitution.
  • the party advocates an “unlimited right” for citizens to be involved in political decision-making, with voters able to propose new legislation and decide on it in national referendums.
  • This election follows the resignation of Iceland’s prime minister, Sigmundur Davið Gunnlaugsson, who became the first major casualty of the Panama Papers
  • “Across Europe, increasingly many people think that the system that is supposed to look after them is not doing it any more,” Jónsdóttir said. “But we know we are new to this, and it is important that we are extra careful and extra critical on ourselves to not take too much on.”
Javier E

A Proud Nation Ponders How to Halt Its Slow Decline - NYTimes.com - 0 views

www.nytimes.com/...-to-halt-its-slow-decline.html

France economy

shared by Javier E on 26 Aug 13 - No Cached
  • Today, however, Europe is talking about “the French question”: can the Socialist government of President François Hollande pull France out of its slow decline and prevent it from slipping permanently into Europe’s second tier?
  • At stake is whether a social democratic system that for decades prided itself on being the model for providing a stable and high standard of living for its citizens can survive the combination of globalization, an aging population and the acute fiscal shocks of recent years.
  • France’s friends, Germany in particular, fear that Mr. Hollande may simply lack the political courage to confront his allies and make the necessary decisions.
  • ...21 more annotations...
  • the challenge in France seems especially hard, in part because of the nation’s amour-propre and self-image as a European leader and global power, and in part because French life is so comfortable for many and the day of reckoning still seems far enough away, especially to the country’s small but powerful unions.
  • as the European economy slowly mends, the French temptation will be to hope that modest economic growth will again mask, like a tranquilizer, the underlying problems.
  • The French are justifiably proud of their social model. Health care and pensions are good, many French retire at 60 or younger, five or six weeks of vacation every summer is the norm, and workers with full-time jobs have a 35-hour week and significant protections against layoffs and firings.
  • the question is not whether the French social model is a good one, but whether the French can continue to afford it. Based on current trends, the answer is clearly no, not without significant structural changes — in pensions, in taxes, in social benefits, in work rules and in expectations.
  • Today, at Nanterre, students worried about finding jobs and losing state benefits are demanding that nothing change at all.
  • “The young people march now to reject all reforms,” he said. “We see no alternatives. We’re a generation without bearings.”
  • The Socialists have become a conservative party, desperately trying to preserve the victories of the last century.
  • There is nonetheless an underlying understanding that there will be little lasting gain without structural changes to the state-heavy French economy. The warning signs are everywhere: French unemployment and youth unemployment are at record levels; growth is slow compared with Germany, Britain, the United States or Asia; government spending represents nearly 57 percent of gross domestic product, the highest in the euro zone, and is 11 percentage points higher than Germany. The government employs 90 civil servants per 1,000 residents, compared with 50 in Germany.
  • Hourly wage costs are high and social spending represents 32 percent of G.D.P., highest among the industrialized countries; real wage increases outpace productivity growth; national debt is more than 90 percent of G.D.P.
  • About 82 percent of the new jobs created last year were temporary contracts, up from 70 percent only five years ago, not the kind of full-time work that opens the door to the French middle class. That keeps nearly an entire generation living precariously, no matter how hard people study or work.
  • Last year, France was ranked 28th out of the 60 most competitive economies in the world, according to the International Institute for Management Development in Lausanne, Switzerland. The United States was first. Even China, at 21, and Japan, at 24, outranked France.
  • In the World Bank’s ranking of “ease of doing business,” France ranks 34th, compared with 7th for Britain and 20th for Germany.
  • France is the world’s fifth-largest economy, with strong traditions in management, science and innovation.
  • The country retains plenty of strengths.
  • The gap between rich and poor is narrower in France than in most Western countries, although it is growing.
  • When the French work, they work hard; labor productivity, perhaps the single most important indicator of an economy’s potential, is still relatively high, if dropping. But with long holidays and the 35-hour week, the French work fewer hours than most competitors, putting an extra strain on corporations and the economy.
  • Large French companies compete globally; there are more French companies in the Fortune 500 than any other European country. But the bulk of their employees are abroad, and there are few of the midsize companies that are the backbone of Germany.
  • Ninety percent of French companies have 10 or fewer employees and fear expansion because of extra tax burdens and strict labor regulations.
  • In poll after poll, the French insist that they want renovation and modernization, so long as it does not touch them. That is always the political challenge, and Mr. Hollande’s conservative predecessor, Nicolas Sarkozy, is considered to have failed in his promise to make serious structural changes.
  • One of Mr. Sarkozy’s advisers, Alain Minc, who tried to get him interested in Germany’s social market revisions, once admitted that Mr. Sarkozy was simply afraid to confront the unions and the social uproar that real change would provoke.
  • There is a broad consensus that real social and structural renovation can be carried out only by the left. But that can happen only if Mr. Hollande, who has a legislative majority, is willing to confront his own party in the name of the future, as the former German chancellor Gerhard Schröder did a decade ago with a series of legal modifications that now get much of the credit for Germany’s revival.
Javier E

Virginia Postrel on the Value of Owning Too Much - WSJ.com - 0 views

online.wsj.com/...4410504575560552064806106.html

possessions Depression clothing discretionary

shared by Javier E on 27 Oct 10 - No Cached
  • In 2008, Americans owned an average of 92 items of clothing, not counting underwear, bras and pajamas, according to Cotton Inc.'s Lifestyle Monitor survey, which includes consumers, age 13 to 70. The typical wardrobe contained, among other garments, 16 T-shirts, 12 casual shirts, seven dress shirts, seven pairs of jeans, five pairs of casual slacks, four pairs of dress pants, and two suits
  • By contrast, consider a middle-class worker's wardrobe during the Great Depression. Instead of roughly 90 items, it contained fewer than 15. For the typical white-collar clerk in the San Francisco Bay Area, those garments included three suits, eight shirts (of all types), and one extra pair of pants. A unionized streetcar operator would own a uniform, a suit, six shirts, an extra pair of pants, and a set of overalls. Their wives and children had similarly spare wardrobes. Based on how rarely items were replaced, a 1933 study concluded that this "clothing must have been worn until it was fairly shabby."
  • Thanks to our bulging closets, over the past couple of decades, clothing has become a much more discretionary good. New purchases are as easy to go without as restaurant meals or entertainment
  • ...1 more annotation...
  • Larger consumer inventories don't just increase variety. They reduce the wear and tear on each individual item, extending its useful life
nrashkind

The Coronavirus Is Forcing American Hospitals to Ration Care - The Atlantic - 0 views

www.theatlantic.com/...609004

shared by nrashkind on 29 Mar 20 - No Cached
  • Hospitals are poised to face the kind of life-and-death decisions that industrialized countries typically encounter only in times of war and natural disaster.
  • wo weeks ago, a man came to an emergency room in New York with pain in the lower-right quadrant of his abdomen.
  • A CT scan showed inflammation around a fingerlike projection at the base of his colon.
  • ...11 more annotations...
  • The next day, recovering upstairs, the man still had a fever. Doctors ordered a test for the coronavirus. A day later, his results came back positive.
  • Last week, the Illinois Department of Public Health sent a notice to clinics that only those people “hospitalized with severe acute lower respiratory illness” could be tested for the coronavirus
  • Today, if every hospital employee who had a close encounter with a COVID-19 patient disappeared for two weeks, the medical workforce would quickly become depleted
  • The virus has an average incubation period of five days, which means people can spread it in the absence of symptoms
  • After the man with appendicitis (a patient of one of the doctors I spoke with for this story) tested positive, the hospital implemented such precautions. And staff members who’d cared for him went into two weeks of isolation.
  • The majority of workers who keep America’s hospitals running don’t have the salary to afford extra bedrooms, much less extra properties
  • During World War II, Ford and General Motors rallied to the cause by building tanks and manufacturing ammunition instead of car
  • The ubiquitous curve is being flattened by shutdowns and social distancing, but it is not flat enough. Those who might end up in a hospital, which is to say all of us, can do at least one thing to help relieve pressure on the medical system and its overtaxed, dwindling workforce.
  • America rolled the dice. For just one example, the federal government has invested only about $500 million annually in the strategic stockpile, maintaining about 12 million N95 masks and 16,600 ventilators. This is enough to equip an area hit by a localized disease outbreak, natural disaster, or terrorist attack. But it is nowhere near what could be necessary in a Disease X pandemic.
  • In January of this year, some Chinese scientists warned that a Disease X had arrived, based on genetic sequencing they’d performed.
  • When we spoke by phone late Tuesday night, as he was driving home from the hospital, he sounded tired. I asked him to think back to the Disease X war game
aleija

A Mathematical Challenge to Obesity - The New York Times - 0 views

www.nytimes.com/...ical-challenge-to-obesity.html

health US opinion

shared by aleija on 09 Aug 13 - No Cached
  • Since the 1970s, the national obesity rate had jumped from around 20 percent to over 30 percent.
  • “Why is this happening?”
  • Why would mathematics have the answer? Because to do this experimentally would take years. You could find out much more quickly if you did the math. Now, prior to my coming on staff, the institute had hired a mathematical physiologist, Kevin Hall. Kevin developed a model that could predict how your body composition changed in response to what you ate. He created a math model of a human being and then plugged in all the variables — height, weight, food intake, exercise. The model could predict what a person will weigh, given their body size and what they take in. However, the model was complicated: hundreds of equations. Kevin and I began working together to boil it down to one simple equation. That’s what applied mathematicians do. We make things simple. Once we had it, the slimmed-down equation proved to be a useful platform for answering a host of questions.
  • ...13 more annotations...
  • With such a huge food supply, food marketing got better and restaurants got cheaper. The low cost of food fueled the growth of the fast-food industry. If food were expensive, you couldn’t have fast food.
  • The epidemic was caused by the overproduction of food in the United States. Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.
  • Well, what do people do when there is extra food around? They eat it! This, of course, is a tremendously controversial idea. However, the model shows that increase in food more than explains the increase in weight.
  • There’s no magic bullet on this. You simply have to cut calories and be vigilant for the rest of your life.
  • Americans are wasting food at a progressively increasing rate. If Americans were to eat all the food that’s available, we’d be even more obese.
  • What new information did your equation render? That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one. Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat. Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.
  • People don’t wait long enough to see what they are going to stabilize at. So if you drop weight and return to your old eating habits, the time it takes to crawl back to your old weight is something like three years. To help people understand this better, we’ve posted an interactive version of our model at bwsimulator.niddk.nih.gov.
  • we should stop marketing food to children.
  • weight change, up or down, takes a very, very long time. All diets work. But the reaction time is really slow: on the order of a year.
  • I could see the facts on the epidemic were quite astounding. Between 1975 and 2005, the average weight of Americans had increased by about 20 pounds
  • People think that the epidemic has to be caused by genetics or that physical activity has gone down. Yet levels of physical activity have not really changed in the past 30 years. As for the genetic argument, yes, there are people who are genetically disposed to obesity, but if they live in societies where there isn’t a lot of food, they don’t get obese. For them, and for us, it’s supply that’s the issue.
  • I think childhood obesity is a major problem. And when you’re obese, it’s not like we can suddenly cut your food off and you’ll go back to not being obese. You’ve been programmed to eat more. It’s a hardship to eat less. Michelle Obama’s initiative is helpful. And childhood obesity rates seem to be stabilizing in the developed world, at least. The obesity epidemic may have peaked because of the recession. It’s made food more expensive.
  • I think the food industry doesn’t want to know it. And ordinary people don’t particularly want to hear this, either. It’s so easy for someone to go out and eat 6,000 calories a day.
katherineharron

The US secured 1 billion doses of Covid-19 vaccines. Medical ethicists say it should sh... - 0 views

www.cnn.com/...index.html

covid

shared by katherineharron on 01 May 21 - No Cached
  • The US has bought or contracted to buy more than 1 billion doses of coronavirus vaccines. That's enough to vaccinate the US population at least twice, with plenty left over.
  • Medical ethicists told CNN the US has a moral duty to share those doses with other countries.
  • he pandemic is relatively under control in the US while countries like India have been overwhelmed by the virus
  • ...17 more annotations...
  • "I do believe that the US is obligated to share vaccines with other countries," said Keisha Ray, an assistant professor and bioethicist at UTHealth McGovern Medical School in Houston, "especially those countries we might consider poorer countries or what we call underdeveloped countries."
  • From an ethical perspective, everyone should have access to protection from Covid-19, Kathy Kinlaw, associate director for Emory University's Center for Ethics, told CNN.
  • many countries lack vaccine access because of the "diminished purchasing power for healthcare in general, but also for Covid-19 treatments and vaccin
  • "I think the United States is definitely in a position where we should be sharing, absolutely,"
  • The US is not simply obligated to share vaccines by virtue of its resources, Ray said. Wealthier countries like the US have historically benefited by hindering other countries, she said, whether through government relations or colonialism.
  • "Now we are in a position to give back, we are in a position to go there and help these countries," she said, like "paying our debt." All three agreed it was right for the US to control its virus outbreaks before sharing vaccines. The pandemic is still an issue in the US, Ray said, but conditions have improved greatly.
  • "You need to stabilize your own nation before you assist others," he said. "And I think we're there. I think we're getting there now."
  • One factor in deciding to release extra vaccines is the issue of supply and demand -- specifically, that the former will soon outstrip the latter in the US, Kinlaw said. And that could mean it's time to start shipping spare doses overseas, she said.
  • "Once this happens," the report said, "efforts to encourage vaccination will become much harder, presenting a challenge to reaching the levels of herd immunity that are expected to be needed."
  • The US needs to continue to address vaccine hesitancy at home and be responsive to peoples' concerns, Kinlaw said. "But certainly there could be a point where there are people who will not take the vaccine and we have extra vaccine in this country, in which case it should be used and shared."
  • Data from the US Centers for Disease Control and Prevention shows that 30% of the US population is fully vaccinated. Experts like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have estimated the US needs between 70% and 85% of the country to be immune -- either through vaccination or prior infection -- to reach herd immunity.
  • "The world's wealthiest nations have locked up much of the near-term supply," wrote Dr. Krishna Udayakumar and Dr. Mark McClellan, health experts at Duke. "At the current rate vaccines are being administered, 92 of the world's poorest countries won't vaccinate 60% of their populations until 2023 or later."
  • "That is an education, a public outreach and an access issue," she said. "We have other hurdles that are not supply hurdles. So we do have the supply to help other countries."
  • "Epidemiologically, we should be working to suppress the virus and to decrease transmission and decrease the continue evolution of the virus and the variants," she said. "That is going to be beneficial to every single person."
  • But vaccinations everywhere could also present economic benefits, Kinlaw said, allowing people to travel more freely and conduct business around the world.
  • "One of the ethical challenges is, are we going to insist on fair distribution within those countries? Or are we just going to give them vaccine and let them give it to the military and elite?" he said.
  • "It sounds nice to say we're going to aid others, but its simplistic, because some governments are corrupt," he said. "Some governments have no distribution plan other than to give it first to their own leaders, rather than to those in need."
annabelteague02

Sen. Kamala Harris introduces bill to lengthen school day by three hours - 0 views

www.cnbc.com/...school-day-by-three-hours.html

harris sen school bill hours politics

shared by annabelteague02 on 06 Nov 19 - No Cached
  • Five-year grants of up to $5 million would go to local educational agencies to push the end of the average school day from 3 p.m. to 6 p.m. in 500 schools.
    • annabelteague02
      annabelteague02 on 06 Nov 19
       
      would people have to be in classes for all this time and would people have to stay even if their parents could pick them up?
  • Teachers and faculty, the bill says, would not have to work additional hours unless they sign up for an extra shift, for which they would be compensated at the rate they get during normal school hours.
    • annabelteague02
      annabelteague02 on 06 Nov 19
       
      so this is essentially just after school care? are there any classes?
  • The bill proposes that the grant money go to extracurricular activities like electives in “music, arts, athletics, writing and engineering,” Harris’ senate office told CNBC. The extra time can also go toward dance and theater programs, among other enrichment activities, the office said. but it leaves the scheduling of the day open to school administrators.
    • annabelteague02
      annabelteague02 on 06 Nov 19
       
      seems like a decent idea! i don't know if it should be mandatory, though
  • ...1 more annotation...
  • In education proposals released during her 2020 campaign for the presidency, Harris said she’d bump the average teacher salary up by $13,500.
    • annabelteague02
      annabelteague02 on 06 Nov 19
       
      how is she going to find the funding for this
katherineharron

Ranking the Top 5 Democrats in the 2020 race - CNNPolitics - 0 views

www.cnn.com/...index.html

shared by katherineharron on 17 Jan 20 - No Cached
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  • 3 (tie). Elizabeth Warren: We're moving the senior senator up on our list for two reasons. First, although Warren is arguably in a worse position than Buttigieg in Iowa and New Hampshire, she is in a better position than he is nationally.
  • 5. Amy Klobuchar: The Minnesota senator wanted (needed?) a star turn at the debate earlier this week in Iowa to close the gap between herself and the four top candidates in Iowa.
  • ...4 more annotations...
  • But the level of not-knowing-what-the-hell-is-going-to-happen is much higher in this race than any we've seen in modern memory. Just four in 10 Iowa Democrats said they were locked in on their candidate choice in a CNN/Des Moines Register poll earlier this month. That's significantly lower than the 59% who said they had made up their minds about a candidate at the same time in 2016.
  • 3 (tie). Pete Buttigieg: Buttigieg is, weirdly, the most divisive candidate in the field. Just take his debate performance on Tuesday night as an example. Chris wrote that he came across as well-versed on the issues, authoritative and possessing the necessary gravitas to serve as commander-in-chief.
  • . Bernie Sanders: We've both written about how it's not far-fetched at all that the junior senator from Vermont could win the nomination.
  • 1. Joe Biden: The former vice president has the easiest path to the nomination. If Biden wins in Iowa, he is the heavy favorite to be the nominee.
mariedhorne

Mail Ballots, Voting Early, Court Fights, Deadlines: What You Need to Know - WSJ - 0 views

www.wsj.com/...t-you-need-to-know-11604142000

voting pandemic election

shared by mariedhorne on 02 Nov 20 - No Cached
  • Record numbers of Americans have voted early in the 2020 election, and more mail ballots are being cast even as voting rules in some states are facing legal uncertainty because of court decisions. Here’s what you need to know about mail ballots and what election officials advise to ensure that your ballot counts.
  • Most states give voters the option of using mail ballots to be sent by post or hand-delivered to drop-off locations, and many have made voting by mail easier in response to the coronavirus pandemic.
  • Roughly 20 states allow extra days for receiving and accepting mail-in ballots so long as they are postmarked by Election Day, or earlier depending on the state. The length of those extensions vary. In Massachusetts and Virginia, for example, it is three extra days, while in California, it is 17.
  • ...2 more annotations...
  • More than 30 states, including some key battlegrounds such as North Carolina and Florida, offer voters who make certain errors that would invalidate their ballots—such as missing or mismatched signatures—a chance to correct them.
  • That debate, with shades of the battles in Bush v. Gore over the 2000 election, has emerged publicly in the run-up to this year’s Election Day.
carolinehayter

Female Physicians Spend More Time With Patients Than Male Doctors Do, But Earn Less : S... - 0 views

www.npr.org/...s-but-earn-less-money-than-men

politics pandemic economics US healthcare

shared by carolinehayter on 30 Oct 20 - No Cached
  • Allen recently read a study published in The New England Journal of Medicine that found female primary care physicians spend more time with their patients than male doctors — an average of 2.4 minutes per visit, to be specific. But female physicians still make less money
  • "The pay gap in medicine by gender is very well documented," Neprash says. "It's been written about for decades, but the understanding of what exactly drives that is pretty sparse."
  • The study's authors analyzed data from over 24 million primary care visits in 2017, digging deep into information from Athenahealth, an electronic medical records company that's widely used in primary care practices.
  • ...19 more annotations...
  • Using "timestamps" that track when patients check in and out, Neprash and her team analyzed exactly how long primary care doctors spent with their patients. They compared male and female physicians not just throughout the country, but within the same practices, which helped control for regional variations in the number of patients doctors are expected to see in a day.
  • Female primary care physicians spent about 15% more time with patients in each visit compared to male primary care physicians. As a result, they saw fewer patients over the course of a year.
  • In the U.S. healthcare system where most insurance companies pay doctors based on the number of patients they see — not how much time they spend with them — this means that women physicians generated about 11% less annual revenue for their practices than their male colleagues.
  • This could account for why female physicians are paid less than men, Neprash argues: They actually spend more time with patients.
  • Often patients come in for a straightforward medical concern, and I find myself discussing how stressed out they are about child care, or how hard it's been to pay the bills on time during the COVID-19 crisis.
  • But by not getting down to business immediately, could I end getting paid less than male doctors?
  • In addition to their visits generally taking longer, women also go to the doctor more than men, and female physicians are more likely to see female patients.
  • In one 2016 study, researchers found that the median salary for male physicians in the United States was almost $86,000 more per year than the median salary for female physicians in the early 2010s.
  • Another study published earlier this year found that in their very first jobs after training, male physicians earned about $36,000 more, on average, than their female counterparts.
  • "When you look at how many minutes they are spending with their patients over a year, female physicians are spending 20 hours more — despite the fact that they're seeing fewer of them, and they're earning less money," Neprash says.
  • Some researchers say female doctors spend more time with their patients, because patients have higher expectations of them.
  • Allen says she feels it's important to ask about her patients' home lives. But that kind of small talk adds up. Many evenings she finds herself still working in the office, long after her male co-workers have gone home.
  • "I do wonder if some of our male colleagues second guess themselves, or go above and beyond in the ways some of us as women tend to do,"
  • "We know that women have longer visits in general. They're twice as likely to raise emotional content in their visits, which generally takes longer to manage."
  • That 2.4 minutes may seem inconsequential. But the New England Journal study authors argue that the extra time female physicians spend with their patients adds up quickly and has profound implications for the pay gap between women and men.
  • Research suggests that the extra time female doctors spend connecting with patients may have a positive impact. One study found significant differences in the practice style of female and male doctors, and found the patients of female physicians tend to be more satisfied with their care.
  • And a widely publicized 2016 study found that when elderly hospitalized patients are cared for by female physicians, they are less likely to die or return to the hospital compared to patients who have male doctors.
  • I became a primary care doctor because I like getting to know my patients as people, not just as a list of diseases. I truly believe it helps me provide better care. But getting to know them takes time, and that means squeezing fewer patients into each workday. That could mean less money for my practice. It seems to be a price that many female primary care physicians are willing to pay.
  • Mara Gordon is a family physician in Camden, N.J., and a contributor to NPR.
Javier E

Another Black Monday May Be Around the Corner - WSJ - 0 views

www.wsj.com/...-rate-federal-reserve-b1df5c21

economy recession 2023 fed money supply history

shared by Javier E on 23 Oct 23 - No Cached
  • When the stock market crashes, “higher for longer” will become a thing of the past as the Fed makes an abrupt pivot. Then the 10-year yields and U.S. dollar will come tumbling down.
  • The Federal Reserve’s policies are threatening U.S. financial markets and the economy. They are in danger of a steep recession and the risk of a repeat of 1987’s Black Monday.
  • Early in the pandemic, the volume of U.S. dollars in circulation soared. For two years starting in March 2020, the M2 money supply—a measure of the cash and checkable deposits in circulation plus savings deposits and other easily convertible assets—grew at an unprecedented annualized rate of 16.5%. That is more than three times the appropriate rate for hitting the Fed’s 2% inflation target.
  • ...13 more annotations...
  • Then, in March 2022, the Fed changed course, first tightening the money supply by increasing the federal-funds rate and then introducing quantitative tightening. Between July 2022 and August 2023, the M2 supply contracted by 3.9%, the most extreme contraction since 1933.
  • The first factor contributing to the contraction of the money supply is the Fed’s quantitative tightening
  • Quantitative tightening has already produced a dramatic selloff in the bond market. But just as they did ahead of the September 2019 crunch in the repurchase-agreement market, Fed officials keep repeating their mistaken mantras that quantitative tightening can operate “in the background” and “on autopilot,” implying minimal market effect
  • But basic balance-sheet accounting shows that unless commercial banks are creating enough “new money” through their lending activity to offset the Fed’s balance-sheet shrinkage, quantitative tightening has a contractionary effect on the money supply.
  • The second factor contributing to shrinking M2 is the decreased availability of commercial bank credit—the sum of loans and bank holdings of securities. With the steep rise in rates, bank lending has slowed, and banks have been selling off securities.
  • This brings us to the stock-market crash of 1987. In that year the key 10-year bond yield rose steeply from January onward (from 7% in January to 10% by Black Monday in October) and the money supply slowed sharply.
  • In 1987 growth of M2 declined by almost half, from 9.7% year-on-year in January to 4.9% in September, while M3—no longer published by the Fed—slowed from 8.7% to 3.6% over the same period
  • A bond-market crunch and monetary squeeze together led to a sudden, drastic reassessment of equity-market valuations. The same could happen today, particularly since the current jump in bond yields and monetary squeeze are much more pronounced than in 1987.
  • So far, only the remaining excess money the Fed created between 2020 and 2021—the cumulative excess savings from the Covid handouts—has been keeping businesses hiring and consumers spending. The effects of the excess money are still giving the economy a lift, but that extra fuel is almost exhausted. When it dries up, the economy will run on fumes.
  • In all of this, an appreciation for time lags is critical. The Fed ignored the huge acceleration in the quantity of money and thus failed to anticipate the ensuing inflation. When inflation struck in early 2021, Fed officials tried to argue it was “transitory,” caused by supply-chain disruptions.
  • The Fed continues to ignore the money supply, and we now face the opposite problem. The money supply has been contracting for 18 months, and soon, after the overhanging extra money from 2020-21 has been used up, spending will plunge and inflation will fall, not simply to 2%, but below—and perhaps even into deflation in 2025.
  • Since Fed officials pay no attention to either monetary aggregates or their credit counterparts, they are overlooking these signals
  • Monetary analysis tells a very different story than the measures the Fed follows. The first effect of a monetary contraction is higher market interest rates for a brief period. Then comes an economic slump. The economy goes into recession and inflation falls. This results in a second and more permanent effect of subpar money growth, namely lower interest rates and a weaker currency.
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