Saturday, December 30, 2006

As Health Middlemen Thrive, Employers Try to Tame Them

Perdue and Caterpillar are grappling with a big issue in U.S. health care: the role of middlemen. Employers are trying to make sure they get their money's worth from intermediaries, some of whom are reaping bonanzas as they stand between patients, doctors and those who pay the bills.

But a lot of the money goes more toward fattening middlemen's bottom lines than toward improving the quality or efficiency of American health care. "At the end of the day, the only reasonable conclusion is that we waste a huge amount of money on the most nuttily cumbersome administrative system in the world," says Henry Aaron, a Brookings Institution economist.
While the middleman business booms, health-care costs keep rising, the ranks of the uninsured grow, and paperwork expands as each party in the system tries to enlarge its slice of the pie. "There's more money to be made by monitoring cash flow than monitoring patients," says David Cutler, a prominent Harvard University health economist.

Friday, December 29, 2006

Yes, There Are Two Americas

Review from the WSJ:
WHO REALLY CARES
By Arthur C. Brooks

(Basic, 250 pages, $26) The book's thesis is offered not as a sermon or platitude -- telling people what they ought to be doing -- but as a work of skillful and intensive empirical research, revealing what people are doing already. Our most pervasive cultural assumptions about the generosity of liberals and the stinginess of conservatives turn out to be almost completely wrong.
(..)

If Mr. Brooks is right, our era's common sense of the matter -- that the political left is more compassionate than the political right, and that America is a remarkably ungenerous nation by world standards -- is demonstrably inaccurate. In fact, Sen. John Edwards's repeated claim that there are "two Americas" turns out to be correct but misstated: The line of separation runs most saliently not between the haves and have-nots but between the gives and the give-nots, between those Americans who respond to social needs with their own money and time and those who do not.

Mr. Brooks speaks here with the authority of a liberal who has been mugged by the data. "These are not the sorts of conclusions I ever thought I would reach,"...
(..)
By consulting a wide range of metrics, ranging from rates of charitable giving to hours of volunteer work donated, Mr. Brooks concludes that four distinct forces appear to have primary responsibility for making people behave charitably: religion, skepticism about the government's role in economic life, strong families and personal entrepreneurship. Those Americans who have all four, or at least three, are much more likely to behave charitably than those who do not...

Wednesday, December 27, 2006

Parrot's Oratory Stuns Scientists

The finding of a parrot with an almost unparalleled power to communicate with people has brought scientists up short.
(..)

The bird, a captive African grey called N'kisi, has a vocabulary of 950 words, and shows signs of a sense of humour.

He invents his own words and phrases if he is confronted with novel ideas with which his existing repertoire cannot cope - just as a human child would do.

N'kisi's remarkable abilities, which are said to include telepathy, feature in the latest BBC Wildlife Magazine.

N'kisi is believed to be one of the most advanced users of human language in the animal world.

About 100 words are needed for half of all reading in English, so if N'kisi could read he would be able to cope with a wide range of material.

Polished wordsmith

He uses words in context, with past, present and future tenses, and is often inventive.

One N'kisi-ism was "flied" for "flew", and another "pretty smell medicine" to describe the aromatherapy oils used by his owner, an artist based in New York.

When he first met Dr Jane Goodall, the renowned chimpanzee expert, after seeing her in a picture with apes, N'kisi said: "Got a chimp?"

N'kisi with picture card and teacher Grace Roselli
School's in: He is a willing learner
He appears to fancy himself as a humourist. When another parrot hung upside down from its perch, he commented: "You got to put this bird on the camera."

50 Things We Know Now (That We Didn't Know This Time Last Year) 2006 Edition

50 Things We Know Now (That We Didn't Know This Time Last Year) 2006 Edition

Beyond Charity: Micro-Lending as Good Business

A good listen on how microfinance is evolving as well as a tribute to Mr. Yunus...

The year's Nobel Peace Prize was awarded to Muhammad Yunus and his Grameen Bank, for their pioneering work in the field of micro-finance, lending money to the poorest of the world's poor.

For the most part, the bulk of the money used in micro-lending has come from philanthropic groups.

But that is beginning to change. High-tech millionaires are providing venture capital. And mainstream investors and institutions are looking at micro-lending as a way to make money while doing good.

Tuesday, December 26, 2006

The Case Against Ladies Night:Drinking Has Hidden Health Risks for Women

Toasting the new year with an alcoholic beverage is probably good for your health -- if you're a man. If you're a woman, the impact of that glass of alcohol is far more confusing.

Overall, science shows that for both men and women, drinking a small amount of alcohol each day is better for you than never drinking at all, and it likely lowers your risk of heart attack, diabetes and mental decline. But for women, moderate alcohol consumption also carries risks you may not know about.

Even small amounts of alcohol consumption are linked with higher risk for breast cancer. Women who drive after drinking are at higher risk than men of dying in a car accident, even at similar blood-alcohol concentrations. And women are at higher risk than men for serious health problems related to alcohol abuse, including liver, brain and heart damage.
(..)

One of the most troubling effects of alcohol is that even small amounts increase a woman's risk for breast cancer. A pooled analysis by Harvard researchers of all the data on alcohol and breast cancer shows that a woman's risk increases by about 9% for every 10 grams of alcohol a day that she drinks. In the U.S., the typical serving of 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor delivers about 12 grams to 14 grams of alcohol, according to the Harvard School of Public Health.

That means a woman who consumes just two drinks a day has about a 27% higher risk of getting breast cancer than a woman who doesn't drink alcohol.

It's worth noting that the absolute risk of alcohol consumption to an individual woman is slight. Consider that the typical 50-year-old woman has a five-year breast-cancer risk of about 2.1% -- so two drinks a day would boost her risk to only about 2.7%....

Monday, December 25, 2006

Saturday, December 23, 2006

Charities in Africa

At this time of the year many of us make our charitable donations.
If you are interested in contributing two charitable causes in Africa,
I would wholeheartedly recommend:
orphansofrwanda.org
and
greeneyesinafrica.org

I know the founders of both of these organizations. They are upstanding and trustworthy individuals with huge hearts..


A sincere thanks to those of you who have already given to these organizations...

Nadia--Jeff Beck

Perhaps while you click on the link to the previous article about global poverty, you might want to let Jeff Beck's wailing guitar play in the background...and let the collective tears of humanity touch your soul...

It was at a concert three years ago, seeing Beck play "Nadia" live after a series of rocked out songs from "You Had It Coming," that sent me into another stratosphere...a moment when time stood still and...well, it was just indescribable

Thank you Brother Al for insisting that I continue to seek and learn of Jeff Beck, even after I mistakenly bought an album from a techno-pop namesake,"Beck," and was utterly confused as to why Brother Al was insisting on the greatness of Jeff Beck.

Thank you Brother Freeze for the tickets to the most transcendent musical moment of my life...

I bow down to both of you....and of course to Jeff Beck--click NOW!

What Should a Billionaire Give – and What Should You?

The iconoclastic Princeton philosopher, Peter Singer, asks what to me is one of the most important questions for all of humanity...As usual the metaphor of children drowning in a well in the midst of a group of adults partying has more impact than the drier logical arguments regarding charity put forth....PLEASE READ...

What is a human life worth? You may not want to put a price tag on a it. But if we really had to, most of us would agree that the value of a human life would be in the millions.
(..)
With Christmas approaching, and Americans writing checks to their favorite charities, it’s a good time to ask how these two beliefs — that a human life, if it can be priced at all, is worth millions, and that the factors I have mentioned do not alter the value of a human life — square with our actions. Perhaps this year such questions lurk beneath the surface of more family discussions than usual, for it has been an extraordinary year for philanthropy, especially philanthropy to fight global poverty.
(..)
According to the Global Forum for Health Research, less than 10 percent of the world’s health research budget is spent on combating conditions that account for 90 percent of the global burden of disease. In the past, diseases that affect only the poor have been of no commercial interest to pharmaceutical manufacturers, because the poor cannot afford to buy their products. The Global Alliance for Vaccines and Immunization (GAVI), heavily supported by the Gates Foundation, seeks to change this by guaranteeing to purchase millions of doses of vaccines, when they are developed, that can prevent diseases like malaria. GAVI has also assisted developing countries to immunize more people with existing vaccines: 99 million additional children have been reached to date. By doing this, GAVI claims to have already averted nearly 1.7 million future deaths.

Philanthropy on this scale raises many ethical questions: Why are the people who are giving doing so? Does it do any good? Should we praise them for giving so much or criticize them for not giving still more? Is it troubling that such momentous decisions are made by a few extremely wealthy individuals? And how do our judgments about them reflect on our own way of living?
(..)
More important than questions about motives are questions about whether there is an obligation for the rich to give, and if so, how much they should give. A few years ago, an African-American cabdriver taking me to the Inter-American Development Bank in Washington asked me if I worked at the bank. I told him I did not but was speaking at a conference on development and aid. He then assumed that I was an economist, but when I said no, my training was in philosophy, he asked me if I thought the U.S. should give foreign aid. When I answered affirmatively, he replied that the government shouldn’t tax people in order to give their money to others. That, he thought, was robbery. When I asked if he believed that the rich should voluntarily donate some of what they earn to the poor, he said that if someone had worked for his money, he wasn’t going to tell him what to do with it.

At that point we reached our destination. Had the journey continued, I might have tried to persuade him that people can earn large amounts only when they live under favorable social circumstances, and that they don’t create those circumstances by themselves. I could have quoted Warren Buffett’s acknowledgment that society is responsible for much of his wealth.
“If you stick me down in the middle of Bangladesh or Peru,” he said, “you’ll find out how much this talent is going to produce in the wrong kind of soil.” The Nobel Prize-winning economist and social scientist Herbert Simon estimated that “social capital” is responsible for at least 90 percent of what people earn in wealthy societies like those of the United States or northwestern Europe. By social capital Simon meant not only natural resources but, more important, the technology and organizational skills in the community, and the presence of good government. These are the foundation on which the rich can begin their work. “On moral grounds,” Simon added, “we could argue for a flat income tax of 90 percent.” Simon was not, of course, advocating so steep a rate of tax, for he was well aware of disincentive effects. But his estimate does undermine the argument that the rich are entitled to keep their wealth because it is all a result of their hard work. If Simon is right, that is true of at most 10 percent of it.
(..)
Is there a line of moral adequacy
that falls between the 5 percent that Allen has given away and the roughly 35 percent that Gates has donated? Few people have set a personal example that would allow them to tell Gates that he has not given enough, but one who could is Zell Kravinsky. A few years ago, when he was in his mid-40s, Kravinsky gave almost all of his $45 million real estate fortune to health-related charities, retaining only his modest family home in Jenkintown, near Philadelphia, and enough to meet his family’s ordinary expenses. After learning that thousands of people with failing kidneys die each year while waiting for a transplant, he contacted a Philadelphia hospital and donated one of his kidneys to a complete stranger.
(..)
If we are obliged to do no more than our fair share of eliminating global poverty, the burden will not be great. But is that really all we ought to do? Since we all agree that fairness is a good thing, and none of us like doing more because others don’t pull their weight, the fair-share view is attractive. In the end, however, I think we should reject it. Let’s return to the drowning child in the shallow pond. Imagine it is not 1 small child who has fallen in, but 50 children. We are among 50 adults, unrelated to the children, picnicking on the lawn around the pond. We can easily wade into the pond and rescue the children, and the fact that we would find it cold and unpleasant sloshing around in the knee-deep muddy water is no justification for failing to do so. The “fair share” theorists would say that if we each rescue one child, all the children will be saved, and so none of us have an obligation to save more than one. But what if half the picnickers prefer staying clean and dry to rescuing any children at all? Is it acceptable if the rest of us stop after we have rescued just one child, knowing that we have done our fair share, but that half the children will drown? We might justifiably be furious with those who are not doing their fair share, but our anger with them is not a reason for letting the children die. In terms of praise and blame, we are clearly right to condemn, in the strongest terms, those who do nothing. In contrast, we may withhold such condemnation from those who stop when they have done their fair share. Even so, they have let children drown when they could easily have saved them, and that is wrong...

Sudan 'accepts UN Darfur force'

Sudan will agree in principle to the deployment of UN troops as part of an expanded peacekeeping force in Darfur, a top Sudanese envoy has confirmed.

Friday, December 22, 2006

Your Turn to Tell the Story: The Darfur Genocide

Stories can be told in countless ways and understood in countless forms. Here’s an invitation to try your hand at a little interactive journalism.

Here’s a link to a collection of columns, videos, and photographs from my recent trip to Chad to covering the spread of the genocide in Darfur. Take a look at the material and, if you’re interested, I’d like to see how you would’ve told the story. Use some of the quotes, the stories, the facts and weave together your own column, essay, article — or some other kind of quilt. I can imagine someone writing a poem, a song, a map, video or audio slide show. Don’t let convention get in the way of your storytelling. And don’t feel as if it needs to be long; hey, a haiku is sometimes more effective than an epic.

I’m eager to see how you’d approach things – what you’d do differently. I hope you do better – these stories are too important to
be told only once.

Please use this form to send me your story by Jan. 10. If it’s a multimedia presentation send us the link via the form. The best will posted here in “On the Ground.”

* Link
* Comments (2)

Wednesday, December 20, 2006

Body Worlds

I saw this exhibit last month in, of all places the MGM Casino, in Las Vegas. As a physician, it was like a refresher course in gross anatomy. But I must say I found the exhibit somewhat distasteful, as the bodies were exhibited in various poses, e.g., throwing a dart. I am relatively sure that the people used in this exhibit did not "consent" to such posing. In fact, I had the eerie feeling that the people in the exhibit were not "asked" whether or not they wanted to be carted off for exhibition in various museums around the world as part of a capitalistic enterprise. Rumors are that these are in fact cadavers of political prisoners. As expected, an email query (by my son) to the website associated with this exhibit elicited no response...

Tuesday, December 19, 2006 "Body Worlds" Heard about the "Body Worlds" exhibit, in which actual eviscerated and dissected human bodies are turned into a plastic-like substance, then posed and exhibited for museum crowds? It's here in Dallas now, and I asked two smart guys to go see it and write their opinions for the section I edit.

Tuesday, December 19, 2006

Window in the Skies



From the Rolling Stone Magazine:
We think this video for U2’s new song “Window in the Skies” is the most sentimental yet ballsy clip we’ve seen in a while. Who besides U2 could appropriate footage of every famous musician — from Sinatra to Elvis to Iggy Pop to Karen O and about 400 others — for their own purposes and end up with something uplifting and tasteful instead of self-congratulatory and distasteful? To Bono we rhapsodize.

Even though we know Elvis isn’t actually singing “oh can’t you see-he-he-heee” in that last black-leather-jacket-featuring frame — but this video makes us feel like he totally meant to.

Which scene is your favorite

Sunday, December 17, 2006

Another video of one of the greatest guitarists ever, Jeff Beck.

Helping Trafficking Victims

Advice from Nicholas Kristof if you want to help organizations fighting human trafficking...

Helping Trafficking Victims

Gotta read it!

This is a great book I read last year...Tom Peters, business guru, apparently agrees!

Okay, it's last year's book. But I just found it in Logan airport at the start of my current Madrid-Paris-L.A. trip. Wow! Fantastic! Amazing!
The book: The Travels of a T-shirt in the Global Economy: An Economist Examines the Markets, Power, and Politics of World Trade, by Pietra Rivoli. The complex issues of trade, globalization, market-power, and market imperfections are brilliantly told via the life of a single T-shirt. Made in China? Obviously! Sorta. How about "Teksa"? The T-shirt "maker," Chinese, patiently explained to the author that this saga starts in Teksa. That is, West Texas, where the cotton is grown. And why is Texas-the U.S.A. still tops in the global cotton market? Um, our markets are not quite as open as we'd like to make the rest of the world believe. There is no "big political message" here. As a professional economist, the author began the story with a very "open markets" bias. It's not that she lost that bias, but that the can of worms (T-shirt) she opened turned out to be, well, full of worms. Nothing is as it seems; think of this as a product of the John LeCarré School of Economics. Though published in 2005, this is my 2006 "book of the year." No issue.

Mad Biking Skills

How the Public School System Crushes Souls

Thoughtful and provocative post here...

Thursday, December 14, 2006

Editorial: Dr. Lawyer

Only in America...

Dec. 14, 2006
Las Vegas Review-Journal

EDITORIAL: Dr. Lawyer


Fearless prediction: Within 20 years, when you visit your family physician seeking relief for that sore throat or stomach bug, you'll have company in the examination room. And your guest won't be a nurse or a medical assistant. Joining you and the good doctor will be ... the doctor's lawyer.

What other recourse will physicians have, given the coming wave of malpractice lawsuits forecast in the journal Tobacco Control?

According to the periodical, research suggests that tobacco companies aren't the only parties at fault in keeping Americans hooked on smokes. The study says doctors can be successfully sued for failing to browbeat their patients into quitting the nasty habit.

"Experience clearly suggests that, faced with a sympathetic and very ill plaintiff who swears that he would have heeded a warning if it had been given, the jury's sympathy for the plaintiff will incline them to award him some damages, even if empirical evidence as well as common experience suggests how hard it often is to quit," John F. Banzhaf III, a George Washington University law professor who's active in tobacco litigation and supports obesity-related lawsuits, wrote in response to the research. Juror "sympathy" could overpower "dry empirical and statistical evidence and related arguments put forth by 'rich doctors and their greedy insurance company lawyers.' "

In fact, the only greedy party here is the trial bar. Such ridiculous litigation isn't about righting a wrong, it's about creating new revenue streams to support golf and yacht club memberships.

So in the near future, don't be surprised to see a lawyer sitting in on your routine physical exam -- or to see him snap on rubber gloves.

Wednesday, December 13, 2006

That Ring Makes a Difference

For Ms. Hymowitz, the two Americas do not divide between the poor who are supposedly in need of government assistance and the rest of us. The division is best defined in another way: between those who see marriage as an indispensable condition of child-rearing and those who don't. If we are becoming two Americas, it is one America in which parents are married and another in which they are not. The Marriage Gap, as Ms. Hymowitz calls it, appears likely to have a more profound effect on the future of both Americas than the gender gap so lamented by the feminists.

Despite the "unmarriage revolution" ushered in by the noxious 1960s, the anti-civilization decade, marriage is again flourishing among well-educated women. Today's educated mothers may work outside the home or not, but they and their husbands are committed to what Ms. Hymowitz calls The Mission -- the project of shaping their children into adults (and citizens) who have the requisite skills and self-discipline to prosper in a complex, postindustrialist society.

The Mission, notes Ms. Hymowitz, requires not a village but two married parents. And, no, cohabitation doesn't do the trick. Even cohabiters who have the education levels of their married counterparts are less effective as parents. "As the core cultural institution," Ms. Hymowitz writes, "marriage orders life in ways that we only dimly understand. It carries with it signals about how we should live, signals that are in line with both our economy and our politics in the largest sense."
(..)

The answer, in Ms. Hymowitz's view, is that many among the urban poor have lost the "life script" for future-oriented child-rearing. Policy makers may assume that the problem is a shortage of employed, marriageable men. But the problem is more existential, a loss of a sense that marriage and children are connected.

Circumcision May Cut Risk of HIV

WASHINGTON - Circumcising adult men may reduce by half their risk of getting the
AIDS virus through heterosexual intercourse, the U.S. government announced Wednesday, as it shut down two studies in Africa testing the link.

Advice I'll Pass Along to My Daughter

In 1985, I graduated from college. This past August, I dropped off my daughter Hannah for her freshman year.

Despite the two decades in between, I can still vividly recall the financial struggles of early adulthood, including grappling with credit-card debt, scrambling to come up with a house down payment and watching as one of my stocks plunged 80% in a few short months.

Hannah, of course, will have her own financial struggles, and those will teach her far more about money than I ever could. Still, there are nine key financial insights I'm hoping to pass along -- and most have precious little to do with picking stocks and buying mutual funds.

Tuesday, December 12, 2006

TimesSelect A Cambodian Girl’s Tragedy: Being Young and Pretty

Is there any greater evil?

Slavery seems like a remote part of history, until you see scholarly estimates that the slave trade in the 21st century — forced work in prostitution and some kinds of manual labor — is probably larger than it was in the 18th or 19th centuries.


Or until you take a rutted dirt path in northwestern Cambodia to a hut between a rice paddy and a river, and meet a teenage girl named Noy Han. The girl, nicknamed Kahan, suffered the calamitous misfortune of being pretty...

(..)
Typically, a girl like Kahan would be imprisoned in a trafficker’s house, tied up and beaten if she resisted, inspected by a doctor to certify her virginity, and sold for hundreds of dollars to a Cambodian or Thai businessman. Virgins are in particular demand by men with AIDS because of a legend that they can be cured by having sex with a virgin.

Afterward, Kahan would have been locked up in a brothel in Pailin, and sold for $10 a session for the first couple of months. The price eventually would drop to $1.50, and by then she would be given greater freedom.
(..)
And slavery is what this is. The real problem isn’t prostitution or trafficking, it’s the enslavement of people.

The Lancet, the British medical journal, once estimated that 10 million children 17 and under may work in prostitution worldwide
. Not all are coerced, but in the nastier brothels of Cambodia, Nepal, India, Malaysia and Thailand, the main difference from 19th-century slavery is that the victims are mostly dead of AIDS by their 20’s.

“It seems almost certain that the modern global slave trade is larger in absolute terms than the Atlantic slave trade in the 18th and 19th centuries was,” notes an important article about trafficking in the current issue of Foreign Affairs...

Craisglist Meets the Capitalists

I love this story!...

Jim Buckmaster, the chief executive of Craigslist, caused lots of head-scratching Thursday as he tried to explain to a bunch of Wall Street types why his company is not interested in “monetizing” his ridiculously popular Web operation. Appearing at the UBS global media conference in New York, Mr. Buckmaster took questions from the bemused audience, which apparently could not get its collective mind around the notion that Craigslist exists to help Web users find jobs, cars, apartments and dates — and not so much to make money.
Wendy Davis of MediaPost describes the presentation as a “a culture clash of near-epic proportions.”
(..)
The Tech Trader Daily blog ponders this question: “If YouTube was worth $1.65 billion, who knows what Craigslist would be worth if Jim and [site founder] Craig Newmark ever considred becoming — what’s the word? — capitalists.”
(..)
Larry Dignan, writing on Between the Lines blog at ZDNet, called Mr. Buckmaster “delightfully communist,” and described the audience as “confused capitalists wondering how a company can exist without the urge to maximize profits.”

Conflict Diamonds In the Spotlight

Charmian Gooch, director and co-founder of Global Witness, will be online Tuesday, Dec. 12, at 2 p.m. ET to discuss the issue of "conflict diamonds" and their links to violence in parts of Africa. The new movie "Blood Diamond," starring Leonardo DiCaprio, is a story of the human cost associated with the mining of diamonds in Sierra Leone.

Monday, December 11, 2006

'Heartless Stone' Tracks Rough Diamond Trade

This insightful interview gives an overviews of the dark side of the diamond trade in West and Central Africa. In speaking with various individuals when I was in Sierra Leone last month, it is clear that diamond mining is the equivalent of gambling here in Nevada. However, instead of sticking coins in a slot machine, these desperately poor people engage in back-breaking labor for pitiful wages in hopes of finding the "big one"...

The film Blood Diamond is about the violent underbelly of the international diamond trade. Writer Tom Zoellner's book The Heartless Stone chronicles how diamonds are mined in some of the world's poorest countries.

Friday, December 08, 2006

Blood Diamonds' Decline, but Not Poverty

More on "Blood Diamonds"

DAKAR, SENEGAL — Hollywood's take on "conflict diamonds" has brought attention back in a big way to how gems associated with wealth and glamour have too often meant war and suffering in Africa.

The film "Blood Diamond," which opened Friday in U.S. theaters, is set in late 1990s Sierra Leone, when the West African country was in the throes of a civil war in which untraceable diamonds allegedly funded fighters who hacked off people's hands with machetes and burned entire villages.

The Best Unlocked Cellphones

If you are thinking of buying a cellphone for a Christmas gift, make a political statement to U.S. wireless carriers, by buying an unlocked one...

Cingular Music applications. Relatively few unlocked phones are sold in the U.S., because they're more expensive than subsidized, locked models. That warps our market, giving the carriers veto power over which phones Americans see. If we buy more unlocked phones, more advanced models will come to our shores as cell phone manufacturers decide we're friendlier to phones that the carriers don't necessarily love.

Blood Diamonds

Check out this link for a preview of the movie coming out, "Blood Diamonds.:

http://video.msn.com/v/us/fv/fv.htm?http://video.msn.com/v/us/v.htm

There are two links in the middle of the page to click regarding the movie.

Thursday, December 07, 2006

If you need a Laugh...

If you need a laugh this morning, as I do...check out this video:

Monday, December 04, 2006

What it Takes to Make a Student

This is a fascinating (albeit long) article on the interesection between class status and academic achievement

...In the first few years of this decade, two parallel debates about the achievement gap have emerged. The first is about causes; the second is about cures.
(..)

Hart and Risley showed that language exposure in early childhood correlated strongly with I.Q. and academic success later on in a child’s life. Hearing fewer words, and a lot of prohibitions and discouragements, had a negative effect on I.Q.; hearing lots of words, and more affirmations and complex sentences, had a positive effect on I.Q. The professional parents were giving their children an advantage with every word they spoke, and the advantage just kept building up.

In the years since Hart and Risley published their findings, social scientists have examined other elements of the parent-child relationship, and while their methods have varied, their conclusions all point to big class differences in children’s intellectual growth. Jeanne Brooks-Gunn, a professor at Teachers College, has overseen hundreds of interviews of parents and collected thousands of hours of videotape of parents and children, and she and her research team have graded each one on a variety of scales. Their conclusion: Children from more well-off homes tend to experience parental attitudes that are more sensitive, more encouraging, less intrusive and less detached — all of which, they found, serves to increase I.Q. and school-readiness. They analyzed the data to see if there was something else going on in middle-class homes that could account for the advantage but found that while wealth does matter, child-rearing style matters more.

(..)
Lareau found that the middle-class families she studied all followed a similar strategy, which she labeled concerted cultivation. The parents in these families engaged their children in conversations as equals, treating them like apprentice adults and encouraging them to ask questions, challenge assumptions and negotiate rules. They planned and scheduled countless activities to enhance their children’s development — piano lessons, soccer games, trips to the museum.

The working-class and poor families Lareau studied did things differently. In fact, they raised their children the way most parents, even middle-class parents, did a generation or two ago. They allowed their children much more freedom to fill in their afternoons and weekends as they chose — playing outside with cousins, inventing games, riding bikes with friends — but much less freedom to talk back, question authority or haggle over rules and consequences. Children were instructed to defer to adults and treat them with respect. This strategy Lareau named accomplishment of natural growth.
(..)
Concerted cultivation, she wrote, “places intense labor demands on busy parents. ... Middle-class children argue with their parents, complain about their parents’ incompetence and disparage parents’ decisions.” Working-class and poor children, by contrast, “learn how to be members of informal peer groups. They learn how to manage their own time. They learn how to strategize.” But outside the family unit, Lareau wrote, the advantages of “natural growth” disappear. In public life, the qualities that middle-class children develop are consistently valued over the ones that poor and working-class children develop. Middle-class children become used to adults taking their concerns seriously, and so they grow up with a sense of entitlement, which gives them a confidence, in the classroom and elsewhere, that less-wealthy children lack. The cultural differences translate into a distinct advantage for middle-class children in school, on standardized achievement tests and, later in life, in the workplace.
(..)

But the real advantages that middle-class children gain come from more elusive processes: the language that their parents use, the attitudes toward life that they convey. However you measure child-rearing, middle-class parents tend to do it differently than poor parents — and the path they follow in turn tends to give their children an array of advantages. As Lareau points out, kids from poor families might be nicer, they might be happier, they might be more polite — but in countless ways, the manner in which they are raised puts them at a disadvantage in the measures that count in contemporary American society.


What would it take to overcome these disadvantages? Does poverty itself need to be eradicated, or can its effects on children somehow be counteracted? Can the culture of child-rearing be changed in poor neighborhoods, and if so, is that a project that government or community organizations have the ability, or the right, to take on? Is it enough simply to educate poor children in the same way that middle-class children are educated? And can any school, on its own, really provide an education to poor minority students that would allow them to achieve the same results as middle-class students?(read on)

"Frikkin Amazing" how nets stop kids' malaria

Video from Sports Illustrated writer who went to Nigeria to distribute bed nets. If link below doesn't work, you can find the video on cnn.com

javascript:cnnVideo('play','/video/us/2006/12/03/stouffer.nets.cnn','2006/12/10');

Sunday, December 03, 2006

Puffing on Polonium

WHEN the former K.G.B. agent Alexander V. Litvinenko was found to have been poisoned by radioactive polonium 210 last week, there was one group that must have been particularly horrified: the tobacco industry.
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The tobacco industry of course doesn’t like to have attention drawn to the more exotic poisons in tobacco smoke. Arsenic, cyanide and nicotine, bad enough. But radiation? As more people learn more about the secrets hidden in the golden leaf, it may become harder for the industry to align itself with candy and coffee — and harder to maintain, as we often hear in litigation, that the dangers of tobacco have long been “common knowledge.” I suspect that even some of our more enlightened smokers will be surprised to learn that cigarette smoke is radioactive, and that these odd fears spilling from a poisoned K.G.B. man may be molehills compared with our really big cancer mountains.

Robert N. Proctor is a professor of the history of science at Stanford University

Thursday, November 30, 2006

The Spirituality of Parenting

This is a fantastic podcast in which the hostess of "Speaking of Faith" interviews a very wise female rabbi,Sandy Eisenberg Stasso. Even those without children will imo find her insights very valuable...You can also listen to it on your computer if you are not an ipod user...HIGHLY RECOMMENDED

More and more people in our time are disconnected from religious institutions, at least for part of their lives. Others are religious and find themselves creating a family with a spouse from another tradition or no tradition at all. And the experience of parenting tends to raise spiritual questions anew. We sense that there is a spiritual aspect to our children's natures and wonder how to support and nurture that. The spiritual life, our guest says, begins not in abstractions, but in concrete everyday experiences. And children need our questions as much as our answers.

Wednesday, November 29, 2006

African Baby Deaths Preventable

More than one million African babies each year die within their first month of life, says a report. The World Health Organisation reveals many newborns are dying from infections which could be cheaply prevented.

Lure of Great Wealth Affects Career Choices

A decade into the practice of medicine, still striving to become “a well regarded physician-scientist,” Robert H. Glassman concluded that he was not making enough money. So he answered an ad in the New England Journal of Medicine from a business consulting firm hiring doctors.

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And today, after moving on to Wall Street as an adviser on medical investments, he is a multimillionaire.
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“There were doctors at the reunion — very, very smart people,” Dr. Glassman recalled in a recent interview. “They went to the top programs, they remained true to their ethics and really had very pure goals. And then they went to the 20th-year reunion and saw that somebody else who was 10 times less smart was making much more money.”

The opportunity to become abundantly rich is a recent phenomenon not only in medicine, but in a growing number of other professions and occupations. In each case, the great majority still earn fairly uniform six-figure incomes, usually less than $400,000 a year, government data show. But starting in the 1990s, a significant number began to earn much more, creating a two-tier income stratum within such occupations.

The divide has emerged as people like Dr. Glassman, who is 45, latched onto opportunities within their fields that offered significantly higher incomes. Some lawyers and bankers, for example, collect much larger fees than others in their fields for their work on business deals and cases.
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Bill Gates and Warren Buffett are held up as models, certainly by Dr. Glassman. “They are going to make much greater contributions by having made money and then giving it away than most, almost all, scientists,” he said, adding that he is drawn to philanthropy as a means of achieving a meaningful legacy.



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Tuesday, November 28, 2006

13 things that do not make sense

13 things that do not make sense

A Favorite Charity That Won’t Accept Donations

An interesting article which fleshes out a doctor's desire to help an individual patient of her's in the context of modern American medicine...


...The idea is preposterous. Even if she would take money, doctors simply do not give it. We give our time and skills; we give out tests, advice and little pieces of paper written in Latin. The various ethical codes that guide our behavior go into some detail about when and from whom we should not accept money. They never bother to discuss when we should not give it out, because, in theory, we never do.

The theory is reasonable: the relationship with patients is complex enough without adding yet another layer of guilt, obligation and responsibility.

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But despite this instructive lesson, I still indulge in fantasies of saving my needy patient with a solid hunk of cash, an anonymous check — enough to buy her food and transportation; expert, consistent medical care; a few treats; and a little something in the bank.

It is an idiotic fantasy. But perhaps no more idiotic than for me to write out checks this month that will cover an infinitesimal fraction of some giant charity’s overhead. No more idiotic than for me to labor over Latin incantations on little scraps of paper in the illusion that they alone will make a difference in my patient’s health and life.

"Blue Jay Spreads His Wings" 60 Minutes

I rarely get a chance to watch "60 minutes," the Sunday night news show on CBS--this used to be a family tradition when I was growing up. But this last Sunday, after an 8 hour drive from Salt Lake City, I plopped down exhausted in front of the TV set and fortuitously "60 Minutes" was on. There were two interesting stories: the "memory erase" pill story in the previous post on this blog, and another segment about an incredible child prodigy composer named Jason Greenberg. At my son, Ryan's piano recital last week, a student had played a very unusual piece entitled, "Storm." It turns out that the composer was Jason, profiled in this piece on "60 Minutes."

CBS) Jay Greenberg is an American composer who some say is the greatest musical genius to come along in 200 years. He wrote five symphonies by the time he was 13 years old.

"We are talking about a prodigy of the level of the greatest prodigies in history when it comes to composition. I am talking about the likes of Mozart, Mendeelsson, and Saint Saens"...Sam Zyman

Pill to Erase Bad Memories--60 minutes

If you experienced a painful or traumatic event, would you want a pill which could lessen the bad memories of what happened? That option might soon be here because of a drug called propranolol.

Monday, November 27, 2006

We're all Racists, Unconsciously

AFTER A PAROXYSM of racial viciousness at the Laugh Factory last week, Michael Richards, the 57-year-old comedian who played Kramer on "Seinfeld," explained to David Letterman and his "Late Night" audience Monday: "I'm not a racist. That's what's so insane about this."

Richards' shattered demeanor and heartfelt repentance leaves us with what I shall call Kramer's Conundrum: How can someone who spews racial epithets genuinely believe he is not a racist? The answer is to be found in the difference between our conscious and unconscious attitudes and our public and private thoughts.

Consciously and publicly, Richards is probably not a racist. But unconsciously and privately, he is. So am I. So are you.
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The insidiousness of racism is because of the fact that it arises out of the deep recesses of our unconscious. We may be unaware of it, yet it lurks there.

How do we know this? One indication is the Implicit Association Test, developed by Harvard scientists, which asks subjects to pair words and concepts. The more closely associated the words and concepts are, the quicker the response to them will be in the key-pressing sorting task (try it yourself at https://implicit.harvard.edu/implicit/ ).

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Richards' sin was his deed; his thoughts are the sin of all humanity. Only when all people are considered to be members of one global in-group (in principle if not in practice) can we begin to attenuate these out-group associations. But it won't be easy. Vigilance is the watchword of both freedom and dignity.

We should accept Richards' apology for losing his temper and acting out those hateful thoughts. Perhaps we also ought to thank him for having the courage to confess in public what far too many of us still harbor in private, often in our unconscious minds. As the Russian novelist Fyodor Dostoyevsky wrote: "Every man has reminiscences which he would not tell to everyone but only his friends. He has other matters in his mind which he would not reveal even to his friends, but only to himself, and that in secret. But there are other things which a man is afraid to tell even to himself, and every decent man has a number of such things stored away in his mind."

Pin the Tail on the Victim

So what is the statute of limitations on stupid, insensitive comments?
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Public opinion now turns on which of our leaders makes the best case for having been persecuted, and which has most effectively used the words "I've suffered" as a substitute for "I'm sorry."

Perhaps this great national game of pin the tail on the victim is truly the best we can do in evaluating the "character" of our leaders. In an era in which every gaffe and blunder is recorded for eternity on YouTube, who among us is really fit to judge whether Lott or Allen is a racist? And who can decide whether the former racists have been reformed and redeemed?

Perhaps this is just too old-fashioned, but I wonder if we could agree that at least part of a person's character can be measured by his ability to say, "I am sorry. I was wrong," as opposed to "I am sorry you victimized me."

Happy Birthday Jimi

Jimi Hendrix would have been 64 years old today

Tuesday, November 21, 2006

Boy's Wish: Kill Them All

The genocide that started in Darfur in 2003 is now threatening to topple the governments of Chad and the Central African Republic. If these two countries collapse into chaos and civil war for years to come, then neighboring countries like Cameroon and Niger will be threatened as well — and the death toll triggered by the Darfur genocide will eventually number in the millions.

None of this was — or is — inevitable. In late 2003 and early 2004, some Republican appointees in the Bush administration (particularly in the Agency for International Development) were among the first to push for a government response to the slaughter in Darfur, but the White House wasn’t interested.

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The most common question I get from readers about Darfur is: What can I do? The simplest answer is to write or call the White House and members of Congress. (See how your representative does on the issue at www.darfurscores.org). Imagine if Mr. Bush had made Darfur an important issue at the Asian summit meeting last week, if he had returned via Cairo for a meeting with Arab leaders, if he had dispatched Condi Rice to Chad to shore it up.

Beyond pushing our own government, we can write the embassies of countries like France and Egypt that could play especially crucial roles. The same is true of China, which provides Sudan the guns used to shoot children like Ismail. We in the news business, including Arab and European television networks, could use a few pokes to appreciate that genocide is newsworthy.

The heroic efforts of aid groups in Darfur and Chad — 13 aid workers have been killed in Darfur since May — deserve support as well. (I list some groups active in Darfur in my blog, nytimes.com/ontheground.) The aid workers risk their lives daily to try to save people, putting up with janjaweed, scorpions, camel spiders and pit toilets inhabited by bats. They can use our backup.

When Young Doctors Strut Too Much of Their Stuff


MIAMI, Nov. 20 — When I was a new faculty physician, I worked with a resident doctor who was smart and energetic and took excellent care of her patients.

There was just one problem. As she delivered her thoughtful patient presentations to me and the other attending doctors, it was hard not to notice her low-cut dress.

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In a study published last year in The American Journal of Medicine, patients surveyed in one outpatient clinic overwhelmingly preferred doctors photographed in formal attire with a white coat to photos of doctors in scrubs, business suits and informal clothes — jeans and a T-shirt for men, an above-the-knee skirt for women. The patients also said they were more likely to divulge their social, sexual and psychological worries to the clinicians in the white coats than to the other doctors.

Plaintiffs’ attorneys sometimes ask about a doctor’s attire in malpractice depositions, Dr. Rowland said. Her research has also found that physician clothing can influence scores on board certification oral exams, in which a senior doctor assesses a younger doctor’s medical knowledge.

“You don’t want to look too attractive to be serious,” she said, adding that “a certain amount of the nerd factor” can help a doctor’s performance.

Okay, so according to the author of the article above, doctors should be careful of how they display their style and beauty--what about beautiful newswomen like Melissa Theuriau?


Stem cells core of more cancers

A spate of new discoveries about the basic biology of cancer is pushing researchers toward an astonishing conclusion: For decades, efforts to cure the disease may have targeted the wrong cells.

Current therapies treat all cancer cells the same. They're aimed at shrinking tumours on the basis that the various cells within them all have similar powers to spawn new cancers and spread destruction.

But mounting evidence suggests that cancer's real culprits -- the roots of perhaps every tumour -- are actually a small subset of bad seeds known best to the world as stem cells.

Monday, November 20, 2006

China's Africa Adventure

This is a very well done 6 page piece about the history of Anhttp://beta.blogger.com/img/gl.link.gifgola and the increasing influence of China in this oil-rich country. It highlights the type of investment relationship that China is creating all over Africa...


Angola is a very, very poor country, but it is also an extremely rich one, for immense deposits of oil lie under the South Atlantic Ocean within its territorial waters. Thanks to the growing appetites of several developing nations, China in particular, that need oil to sustain the furious expansion of their economies, last year Angola, which otherwise has almost no economy, had more than $10 billion to play with. And it has used that money to pay more advanced countries to rebuild its infrastructure. This vision — call it “Development by China” — looks like a catastrophic mistake to the Western experts and institutions that have scrutinized, invested in and at times despaired of Angola.
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Angola traditionally exported not only oil but diamonds, iron ore, cotton, sisal and corn. But Portugal, Angola’s colonial master for four centuries, abruptly abandoned the country in 1975, provoking a civil war between a government backed by the Soviet Union and Cuba, and Unita, a rebel force supported by South Africa and the United States. The war waxed and waned through stalemates, cease-fires and even, in 1992, an election. By the end, in 2002, more than a million people had died and about a third of Angola’s population of 12 million had fled from their homes. The war reduced Angola to a beggar nation, dependent on handouts from the World Food Program.
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The one industry that continued to function throughout the war was oil, for even Angola’s fighting couldn’t spread to the ocean floor. Oil revenue allowed the regime of President José Eduardo dos Santos, who took power in 1979, to buy weapons and mercenaries, and ultimately to destroy the Unita army. A bizarre wartime financial system evolved in which revenue flowed into the national oil company, known as Sonangol, and then . . . disappeared.
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Vast sums — no one knows how much — were stolen by members of the regime. By the mid-’90s, the government was running enormous deficits, and inflation was zooming past 1,000 percent. The end of the cold war had deprived Angola of its Soviet patron; the regime, which in 1990 officially forswore Marxist-Leninist doctrine and supposedly began making a transition to a market economy, now turned to the West for help. But the United States and other donor nations no longer needed to prop up sympathetic dictators. And they had learned, through painful experience, that aid given to corrupt regimes with opaque financial systems was bound to be wasted.
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An I.M.F. team that came in 2002 to help the country put its financial affairs in order was flabbergasted by Angola’s Potemkin economy, and even more by the nonchalance of its leading officials.
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After the I.M.F. report, the United States and Britain pulled out, and Angola, still deeply in debt despite billions in oil revenue, was left to bitterly contemplate its options.
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And China offered a model of development, driven from above and powered by high-tech investment, vastly more gratifying and reassuring to third-world elites than the Western gospel of unleashing growth through democratic and marketplace reform. Western donors, led by the I.M.F., conditioned aid on the achievement of meaningful, and often painful, reform. China, by contrast, offered aid without “conditionality.” According to China’s official African policy, published earlier this year, China seeks “a new type of strategic partnership,” which, among other things, “respects African countries’ independent choice of the road of development.” China invokes this doctrine of noninterference when defending the grossly abusive regimes in Sudan, Zimbabwe, Eritrea and elsewhere with which it carries on a flourishing business.
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By 2003, the regime in Angola was every bit as disgusted with the I.M.F. as the I.M.F. was with it.
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In November 2003, Angola’s finance minister traveled to China to discuss a financial package. One year later, China announced that it had extended to Angola a $2 billion oil-backed loan, an Angolan specialty in which credit is secured by future oil production — just the kind of risky gimmick the I.M.F. had preached against. China uses its foreign aid as a means to promote opportunities for private investment, and the two countries agreed that Chinese construction companies would build the giant infrastructure projects financed by the loans.

China immediately began to increase its purchase of Angolan oil; by early this year, Angola had replaced Saudi Arabia as its single-largest source of oil. The extent of China’s commitment to Angola became stunningly clear this spring, when Sinopec, a Chinese state-owned energy company, bid $2.2 billion for the right to develop two deep-water blocks — a sum that shattered all previous records anywhere in the world.
Sinopec made its investment in partnership with Sonangol. The billions China offered astonished the Western oil companies, which had already explored adjacent areas and had submitted only modest bids.
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Everything seems to be breaking right for Angola just now. Angola is swimming in oil money. Last year’s oil revenue of $10.6 billion was almost double the figure from 2004. A recent report by The Economist Intelligence Unit projects the country’s growth rate at 16.7 percent this year and 20.8 percent in 2007, making Angola’s one of the world’s fastest-growing economies
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And yet this is the same country where one out of three children dies before reaching the age of 5, where average life expectancy is 38, where cholera, polio and hemorrhagic fevers like the Marburg virus flourish — a country that ranks 160th out of the 177 countries on the United Nations’ Human Development Index. How, and when, will the cataract of oil money flow down the hill from Luanda Sul to improve the lives of Angola’s impoverished, war-weary citizens?
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“If you don’t have roads, if you don’t have bridges, if you don’t have the energy system, electricity, water,” he said, “how can you expect the private sector to invest in such a country?” Yes, he said, Angola needed to pay teachers better. “But public expenses for personnel account for 50 percent of the current budget. Some people”—I.M.F.-type people, presumably —“say that you have to bring down your expenses for personnel. How do you solve that in a postconflict situation? Do you create massive unemployment?”
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Jaime had, of course, glossed over the untold sums lost to corruption, but he had also neglected to mention another distinctly Angolan factor: the combination of war, theft and indifference to the plight of the ordinary Angolan had rotted away the machinery of government. The state’s capacities, whether in regard to bricklayers or teachers or civil servants, or banks, or power grids, were so feeble that any attempt to push all those billions through normal government channels would produce a colossal blockage. The only way to actually put the money to use was to pay the Chinese — or the Portuguese or the Brazilians — to build things. And so Angola was spending staggering sums to repair its infrastructure: $2.7 billion for a dam in the north, $4 billion for three railway lines, including the one that ran through Huambo. The regime wouldn’t be able to provide a public health care system or a skilled work force for years, but it could deliver passable roads. And roads mattered. “By the end of 2007,” Jaime grandly predicted, “most roads linking main production centers will be finished, and the economy will just jump.”(..)
China is now one of Africa’s largest customers not only for oil but also for timber, minerals, cotton and other natural resources. China in turn has flooded Africa with cheap consumer goods. The I.M.F. forecasts that China’s trade with Africa will top $50 billion this year and could reach $100 billion by 2010. Over the last five years, sub-Saharan Africa’s growth rate has almost doubled, to 5.8 percent from 3 percent; economists attribute much of the increase to trade with China and other Asian countries.
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The People’s Republic has declared 2006 “the Year of Africa.” The West had its own unofficial Year of Africa in 2005, and it is instructive to compare the two.
The industrial nations conducted a sort of moral crusade, with advocacy organizations exposing Africa’s dreadful sores and crying shame on the leaders of wealthy nations and those leaders then heroically pledging, at the G8 meeting in July, to raise their development assistance by billions and to open their markets to Africa. Once everyone had gone home, the aid increase turned out to be largely ephemeral and trade reform merely wishful. China, by contrast, offers a pragmatic relationship between equals: the “strategic partnership” promised in China’s African policy is premised on “mutual benefit, reciprocity and common prosperity.”
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If we believe that a model of development that strengthens the hand of authoritarian leaders and does little, if anything, to empower the poor is a bad long-term strategy for Africa, then we are going to have to come up with a strategic partnership of our own. And it is not only a question of what is good for the African people. The United States has a real security interest in avoiding failed states and in blocking the spread of terrorism in East and North Africa. What’s more, the United States already imports 15 percent of its oil from Africa, mostly from Angola and Nigeria; that figure is bound to rise and could even double, eventually making Africa as large a supplier of oil as the Middle East now is. China’s Africa policy shows that globalization is increasingly divorced from Westernization. We have grown accustomed to the idea that Africa needs us; it’s time to recognize that we, like China, need Africa.

Thursday, November 16, 2006

Stephen Colbert Election NIght Rant

I have been waiting for this clip to appear on the net. (Tip of the hat to Freeze for finding it)...

U.S. Bombards Insurgents with Negative Ads

The latest from Andy Borowitz...

In a bold change of strategy in the war in Iraq, President George W. Bush announced today that the U.S. had begun bombarding Iraqi insurgents with negative ads in the hopes of bringing the insurgency to its knees.

At a White House briefing today, spokesman Tony Snow said that the new military campaign, called Operation Relentless Smear, would focus on attacking the personal missteps and hypocrisies of key Iraqi insurgents on a twenty-four-hour basis.

"This new strategy is playing to our strengths," Mr. Snow told reporters. "The insurgents are good at blowing things up and creating chaos, but no one is better than we are at creating negative ads."

According to Mr. Snow, Operation Relentless Smear will re-deploy thousands of negative ad producers, directors, and voiceover artists who were momentarily idle at the conclusion of the U.S.'s midterm election campaign.

Masterminded by the White House's top political strategist Karl Rove, the bombardment of negative ads began at midnight Wednesday, interrupting all local Iraqi programming with a nonstop diet of half-truths, corrosive accusations and character assassination.

By Thursday morning, there were already signs that Operation Relentless Smear was working, as Iraqi insurgents in such key cities as Baghdad and Tikrit appeared worn out by the onslaught of slickly produced attack ads.

"The air strikes and the curfews were one thing," said Hassan El-Medfaii, an insurgent who is based in Baghdad's Sadr City district. "But this is messing with my TV."

Elsewhere, US Airways made an $8 billion bid for Delta, including $4 billion in cash and $4 billion in lost luggage.

Wednesday, November 15, 2006

In Medicaid, Private HMOs Take a Big and Profitable Role

Some 55 million poor and disabled Americans are covered by Medicaid. With an annual price tag topping $300 billion, it's among the biggest government programs around.

It's also a lucrative business for some private companies that act as middlemen between the government and patients. Instead of directly paying the bills when a Medicaid patient goes to the doctor, state governments increasingly outsource the job to private contractors. More than one in three Medicaid beneficiaries now receive care through a private insurer.


The potential gains are big. Four years ago, a private-equity fund in which George Soros was the largest investor took a 70% stake in WellCare Health Plans Inc., a leading Medicaid health-maintenance organization. The fund finished cashing out the stake this August, bringing in a total of $870 million for an investment that originally cost $220 million.

Four of the biggest Medicaid HMOs -- WellCare, Centene Corp., Molina Healthcare Inc. and Amerigroup Corp. -- have seen their shares surge on the New York Stock Exchange over the past few years, although prices of the latter three have been volatile. WellCare's stock price has tripled since it began trading in July 2004, bringing the value of stock and options held by its chief executive, Todd S. Farha, to $77 million.

The companies are growing fast. Centene boasts nearly 1.2 million members and posted $1.5 billion in revenue last year. That compares with 142,000 members and $200 million in revenue six years earlier.

With the growth has come criticism from some doctors and patients who accuse Medicaid HMOs of scrimping on care. Even as they restrict medical tests and use of prescription drugs, the companies spend the money they get from states on items that don't have an obvious connection to patients. Centene has funded a multimillion-dollar arts center in St. Louis and paid to put its name on stadiums in Montana and Missouri. The HMOs are also big donors to political campaigns.

Link:http://online.wsj.com/article/SB116354350983023095.html?mod=djemHL (subscription required)

Thursday, November 09, 2006

Gorillas Harbor AIDS like virus

This was a concern in the back of my mind when bush meat was served for dinner when I was in Sierra Leone last month...

PARIS (AFP)—Gorillas appear to be widely infected by a close relation to the AIDS virus, according to a study that appears in the British journal Nature.

French scientists made the startling discovery—which has wide implications for the illegal market in bushmeat
—as they were looking for traces of the simian immunodeficiency virus (SIV) among chimpanzees.

Monday, November 06, 2006

The Beauty of Mathematics

The Beauty of Mathematics: http://canadared.blogspot.com/2006/11/beauty-of-mathematics.html

Some Nevada doctors are flat-lining over reimbursement plans

This article highlights some experiences that jibe with our experience in the practice ofophthalmolog in Nevada. The article misses the fact that Blue Cross Blue Shield also provide minimal coverage for their patients--it is a moneymaking monster for itself, that rips off patients and doctors...


LAS VEGAS (AP) -- Some Nevada doctors are flat-lining economically over reimbursement plans they say are too low. The dilemma could force many to leave a state that already faces a shortage of doctors, according to the president of the Nevada Association of Family Physicians.

"We're chasing our tails. We're in a losing game," said president Bill Pierce.

Pierce's solo family doctor practice in 2005 brought in a half-million dollars, but he ended up $32,000 in the hole. He took out a $100,000 home-equity loan to cover the difference.

Today's world of health care has forced Pierce to be as much a businessman as a healer and he said he's not alone.

Doctors' biggest challenge these days is not treating ailing patients but navigating a complex maze of reimbursements from 150 insurance companies, he said.

Each insurer reimburses doctors at different amounts based on separately negotiated contracts - and physicians' revenues can drop even as costs increase.

Pierce estimates he needs to generate $272 an hour to cover his costs - from malpractice insurance to rent.

That means seeing dozens of patients every day. He doesn't want to treat them as so many widgets, so he tries to spend a decent amount of time with each. But that just gets him in financial trouble.

His practice has 4,300 patients. A third of them are covered by Anthem Blue Cross and Blue Shield. It used to pay Pierce $66.53 to see a patient for a typical 20-minute visit. It was recently cut to $47.37, some of which may be paid directly by the patient.

By comparison Medicare, the federal government's insurance program for people who are disabled or over age 65, pays $84.51 for the same type of visit, Pierce said, though those rates are also expected to drop.

The reimbursement rules mean that sometimes it pays more for the doctor to inconvenience patients, he said.

For example, when a Blue Cross patient needed a skin lesion removal, a procedure that takes 30 minutes of staff time, Pierce had the option of delaying the procedure to a future visit and receiving about $30 from Blue Cross. Instead, he removed it immediately and was reimbursed 73 cents.

In most industries, business owners can charge more when their costs rise, but that's not the case for doctors.

Dr. Florence Jameson, an obstetrician-gynecologist and president of the Clark County Medical Society, said many doctors are forced to join groups and share administrative costs. The solo practice, she said, may become a relic.

"It is a big deal and it's a sad thing, and it's unfortunate that medicine now is just big business, it's now corporate," Jameson said. "It will never go back to the way it was 20 or 30 years ago. Too many people have found out how lucrative it is to be a middle man in medicine."

Jameson said insurance companies are forcing family doctors to change the way they practice. For example, many doctors are extending the reach of their practices by using more physician assistants or nurse practitioners to treat patients. Fewer patients are treated by doctors.

Pierce said he can't keep up with the insurance companies' changing rules and guidelines.

He just knows one thing: If they cut back on how much they reimburse him to see their customers, he may be forced to stop seeing them. Other doctors have dropped patients for the same reason - inadequate insurance reimbursements.

Pierce said he is forming an additional branch of his practice that will bypass insurance companies.

Patients who join the program - tentatively called Your MD -would eliminate their comprehensive health coverage. Instead, they would carry less-expensive catastrophic coverage and pay Pierce $2,000 a year - about what many people pay for health insurance - for up to 10 visits, annual lab work and a nutritional assessment.

He said he would limit the number of patients in the new program to 600, so they can have his full attention. In return, he'll get paid up front by patients.

And he won't have to deal with their insurance companies.

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Information from: Las Vegas Sun, http://www.lasvegassun.com

Saturday, November 04, 2006

Dave Chapelle as Rapper Li'l John

Make sure you watch this video all the way through the end for some good laughs...

Monday, October 30, 2006

Africa’s World of Forced Labor, in a 6-Year-Old’s Eyes




This article highlights the miserable life of child slaves in Western Africa. My experiences in Africa seem to confirm much of what this article states regarding the lack of respect for individual life, the differing attitudes toward children between here and much of the third world, the terrible choices people make in the face of overwhelming poverty...

Mark Kwadwo is 6 years old. About 30 pounds, dressed in a pair of blue and red underpants and a Little Mermaid T-shirt, he looks more like an oversized toddler than a boat hand. He is too little to understand why he has wound up in this fishing village, a two-day trek from his home.

But the three older boys who work with him know why. Like Mark, they are indentured servants, leased by their parents to Mr. Takyi for as little as $20 a year.

Until their servitude ends in three or four years, they are as trapped as the fish in their nets, forced to work up to 14 hours a day, seven days a week, in a trade that even adult fishermen here call punishing and, at times, dangerous.

Mr. Takyi’s boys — conscripts in a miniature labor camp, deprived of schooling, basic necessities and freedom — are part of a vast traffic in children that supports West and Central African fisheries, quarries, cocoa and rice plantations and street markets. The girls are domestic servants, bread bakers, prostitutes. The boys are field workers, cart pushers, scavengers in abandoned gem and gold mines.
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The International Labor Organization, a United Nations agency, estimates that 1.2 million are sold into servitude every year in an illicit trade that generates as much as $10 billion annually.
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John R. Miller, the director of the State Department Office to Monitor and Combat Trafficking in Persons, said the term trafficking failed to convey the brutality of what was occurring.

“A child does not consent,” he said. “The loss of choice, the deception, the use of frauds, the keeping of someone at work with little or no pay, the threats if they leave — it is slavery.”

Some West African families see it more as a survival strategy. In a region where nearly two-thirds of the population lives on less than $1 a day, the compensation for the temporary loss of a child keeps the rest of the family from going hungry. Some parents argue that their children are better off learning a trade than starving at home.

(..)

To reduce child trafficking significantly, said Marilyn Amponsah Annan, who is in charge of children’s issues for the Ghanaian government, adults must be convinced that children have the right to be educated, to be protected, and to be spared adult burdens — in short, the right to a childhood.

“You see so many children with so many fishermen,” she said. “Those little hands, those little bodies. It is always very sad, because this is the world of adults.
(..)

“It was hunger, to get a little money; the whole today, I have not eaten,” said Efua Mansah, whose 7-year-old son, Kwabena, boarded a small blue bus with Mr. Takyi four years ago for the 250-mile trip to Kete Krachi.

She has seen him only twice since then. In all that time, Mr. Takyi has paid her $66, she said, a third of which she spent on buses and ferries to pick up the money.

(..)

Mr. Takyi, who sleeps and works in the same gray T-shirt, is disarmingly frank about his household. He can afford to feed the children only twice a day, he said, and cannot clothe them adequately. He himself has been paddling the lake since age 8.

“I can understand how the children feel,” he said. “Because I didn’t go to school, this is work I must do. I also find it difficult.”

Yet he does not hesitate to break a branch from the nearest tree to wake the boys for the midnight shift.

“Almost all the boys are very troublesome,” he complained. “I want them to be humble children, but they don’t obey my orders.”
(..)

Running away is a common fantasy among the boys. Kofi Nyankom, who came from Mark’s hometown three years ago, at age 9, was one of the few to actually try it.

Last December, he ran to town half-naked, his back a mass of bruises. He said Mr. Takyi had tied up him and whipped him.

Wednesday, October 25, 2006

Tuesday, October 24, 2006

The Garden of Earthly Delight

With Her Malawi Adoption, Did Madonna Save a Life or Buy a Baby?

Viewpoint: The problem is that David was no orphan, and moral instinct tells us that a father's love should count for something

Madonna is so easy to revile that you start to wish she'd make it a little harder. She knows symbolism like a Renaissance painter, and so you wonder whether all her world really is a stage, whether she knew that the whole world would watch her dance in the dusty Malawian village in her crisp white linens with the cosmically cute baby boy strapped to her back; that the press would be there waiting, scribbling, flashing when Baby David arrived with a bodyguard and nanny to join Madonna in her $15 million London home. Did she hope that by courting controversy, the stories that followed would get around to mentioning that Baby David's his life expectancy was in the process of doubling from 40 in Malawi to 78 in Britain? Or that she has donated $3 million to help 900,000 Malawian orphans with food, school, shelter?

Behind America's Different Perceptions of God


Chck out the graphic in the article: "How we view God"


An extensive survey divided religion into four ways of seeing God, which they say is a better indicator of political and moral attitudes than denomination

Iraq and Your Wallet

For every additional second we stay in Iraq, we taxpayers will end up paying an additional $6,300.

So aside from the rising body counts and all the other good reasons to adopt a timetable for withdrawal from Iraq, here’s another: We are spending vast sums there that would be better spent rescuing the American health care system, developing alternative forms of energy and making a serious effort to reduce global poverty.
(..)

But now several careful studies have attempted to tote up various costs, and they suggest that the tab will be more than $1 trillion — perhaps more than $2 trillion. The higher sum would amount to $6,600 per American man, woman and child.

“The total costs of the war, including the budgetary, social and macroeconomic costs, are likely to exceed $2 trillion,” Joseph Stiglitz, the Nobel-winning economist at Columbia

(..)

Just to put that $2 trillion in perspective, it is four times the additional cost needed to provide health insurance for all uninsured Americans for the next decade.

(..)

The administration didn’t raise taxes to pay for the war, so we’re financing it by borrowing from China and other countries. Those borrowing costs are estimated to range from $264 billion to $308 billion in interest.
(..)

The bottom line is that not only have we squandered 2,800 American lives and considerable American prestige in Iraq, but we’re also paying $18,000 per household to do so.

We still face the choice of whether to remain in Iraq indefinitely or to impose a timetable and withdraw U.S. troops. These studies suggest that every additional year we keep our troops in Iraq will add $200 billion to our tax bills.

My vote would be to spend a chunk of that sum instead fighting malaria, AIDS and maternal mortality, bolstering American schools, and assuring health care for all Americans. We’re spending $380,000 for every extra minute we stay in Iraq, and we can find better ways to spend that money.

(subscription required)

War in Sudan? Not Where the Oil Wealth Flows

War in Sudan? Not Where the Oil Wealth Flows

Despite the image of Sudan as a land of cracked earth and starving people, the economy is booming, with little help from the West. Oil has turned it into one of the fastest growing economies in Africa — if not the world — emboldening the nation’s already belligerent government and giving it the wherewithal to resist Western demands to end the conflict in Darfur.

American sanctions have kept many companies from Europe and the United States out of Sudan, but firms from China, Malaysia, India, Kuwait and the United Arab Emirates are racing in. Direct foreign investment has shot up to $2.3 billion this year, from $128 million in 2000, all while the American government has tried to tighten the screws.
(..)

But the country’s G.D.P. grew 8 percent in 2005, according to the International Monetary Fund, and is predicted to increase by 12 percent this year. Cotton and other agricultural products have traditionally been the engines of the economy here, but the new growth comes largely because Sudan has substantially increased its crude oil production to 512,000 barrels a day — a drop compared with Saudi Arabia’s or Iran’s, but enough to bring billions of dollars to a country that until recently was one of the poorest on earth.
(..)

The traditional meal of ful, a bean stew eaten for breakfast and lunch, is giving way to kebabs, yogurt, hamburgers and hot dogs.

“We even have Pringles,” said Mohammed Abdelwahab Salih, a 26-year-old entrepreneur who recently started a business in Khartoum designing Web sites.

Mr. Salih remembers the days, not so long ago, when he used to have to wait in line for hours for a single loaf of bread.

“And it wasn’t even good bread,” he said. “When we got home, we had to pick out the flies.”

(..)

“The Americans are not a threat, but if the international community lines up against us, ahh, that is a different issue,” said Osama Daoud Abdellatif, chairman of the DAL Group, a conglomerate that owns the Coke factory, the Ozone Café and a number of other businesses. “Everything has been going so well, but Darfur could spoil the party.”

Worrisome New Link: AIDS Drugs and Leprosy

With affordable AIDS drugs arriving in many poor countries, experts say a startling and worrisome side effect has emerged: in some patients, the treatment uncovers a hidden leprosy infection.
(..)

And in the third world, where 300,000 new cases of leprosy were discovered last year and where 38 million are infected with the AIDS virus, the problem will inevitably get worse, experts say.

“This is just the peak of the iceberg,” said Dr. William Levis, who treats leprosy patients at Bellevue Hospital in New York City. “It’s early in the game. Most physicians don’t even think about leprosy, so there’s probably much more around than we know.”
(..)

Experts say the problem arises when the AIDS drugs cause the immune system to recover. It then generates new white blood cells that carry the bacteria from old, silent leprosy infections to the skin of the face, hands and feet.

That is a new twist on a medical paradox that has confounded tropical-disease specialists for 20 years....

Monday, October 23, 2006

A new use for google earth

Beginning Sunday evening, when you check out Google Earth's map of the United States, you'll see little stars bearing the likeness of the American flag dotting the landscape. Click on the one where you live, and a box will come up with the candidates running for House and Senate seats. The list goes beyond Ds and Rs to include the Green Party and even the Pirate Party candidate in Iowa.

The most practical feature is the link in each box to a Web site often used by reporters, the Center for Responsive Politics. Here, you can check out the political contributions each candidate has received and follow the money yourself.

Sunday, October 22, 2006

Darfur on 60 minutes tonight

Anti-Genocide Activists,

Tonight, CBS� �60 Minutes� will air a report by journalist Scott Pelley about the continuing genocide in Darfur � along with the remarkable story of a boy�s schoolbooks found in the ashes of his burned home.

Pelley, denied a visa by Sudan, sneaks across the border from Chad in search of the boy, swept into the heart of the first genocide of the twenty-first century.

Watch a preview of the report.

The episode will air tonight at 7:00 PM Eastern/Pacific. For more information, check the CBS website.

Wednesday, October 18, 2006

Can You Tell a Sunni From a Shiite?

Incredible...(but not surprising I guess)

FOR the past several months, I’ve been wrapping up lengthy interviews with Washington counterterrorism officials with a fundamental question: “Do you know the difference between a Sunni and a Shiite?”

A “gotcha” question? Perhaps. But if knowing your enemy is the most basic rule of war, I don’t think it’s out of bounds. And as I quickly explain to my subjects, I’m not looking for theological explanations, just the basics: Who’s on what side today, and what does each want?

After all, wouldn’t British counterterrorism officials responsible for Northern Ireland know the difference between Catholics and Protestants? In a remotely similar but far more lethal vein, the 1,400-year Sunni-Shiite rivalry is playing out in the streets of Baghdad, raising the specter of a breakup of Iraq into antagonistic states, one backed by Shiite Iran and the other by Saudi Arabia and other Sunni states.
(..)

But so far, most American officials I’ve interviewed don’t have a clue. That includes not just intelligence and law enforcement officials, but also members of Congress who have important roles overseeing our spy agencies. How can they do their jobs without knowing the basics?

Barney and Baghdad

Friedman arguing that the Jihadists are trying to influence U.S. elections...

Total U.S. troop deaths in Iraq this month have reached at least 53, putting October on a path to be the third deadliest month of the entire war for the U.S. military. Iraqis are being killed at a rate of 100 per day now. The country has descended into such a Hobbesian state that even Saddam called on Iraqis from his prison cell to stop killing each other. He told insurgents, “Remember you are God’s soldiers and, therefore, you must show genuine forgiveness and put aside revenge over the spilled blood of your sons and brothers.” When Saddam is urging calm, you know things have hit a new low. (subscription required)

Tuesday, October 17, 2006

African Stocks Outpace Emergent Peers

LONDON -- Emerging markets from Asia to Latin America got a rude awakening earlier this year when investors withdrew money on fears of a global economic slowdown.

Markets across Africa, though, are showing some of the best returns of the year
, outperforming the benchmark MSCI Emerging Market Index of global emerging-market stocks, amid their relative isolation from global capital flows and economic growth.

(..)

While the MSCI index fell 11% in May, however, two of Africa's most-promising sub-Saharan markets, Kenya and Nigeria -- which have both more than doubled in size in U.S. dollar terms during the past three years -- rose 6.5% and 5.6% respectively, according to Investec Asset Management.

Kenya's Nairobi Stock Exchange has seen its NSE 20 share index rise 20% in U.S. dollar terms from January through September while Nigeria's All Share Index is up 40%, according to Liquid Africa, a financial-services company based in South Africa that tracks 19 African stock exchanges on its Web site.

Indeed, the continent's so-called frontier markets, such as Nigeria, Kenya, Ghana, Mauritius and Botswana, are up an average of 26% so far this year in dollar terms, according to Liquid Africa. By comparison, the MSCI Emerging Market Index, which includes just three African countries -- South Africa, Egypt and Morocco -- has risen 9.5% during the same period.

Most of the markets are tiny, often with stock-market capitalizations of less than $3 billion, and most stocks are illiquid. Although there are few restrictions to foreign investment, few mutual funds in the U.S. and Europe invest in them. Total market capitalization across the continent's major markets totaled $791.7 billion in August according to Liquid Africa -- around a fifth of the size of the London Stock Exchange. South Africa is by far the dominant market with $527 billion capitalization.
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