Kilian Jornet Burgada is the most dominating endurance athlete of his generation. In just eight years, Jornet has won more than 80 races, claimed some 16 titles and set at least a dozen speed records, many of them in distances that would require the rest of us to purchase an airplane ticket. He has run across entire landmasses (Corsica) and mountain ranges (the Pyrenees), nearly without pause. He regularly runs all day eating only wild berries and drinking only from streams. On summer mornings he will set off from his apartment door at the foot of Mont Blanc and run nearly two and a half vertical miles up to Europe’s roof — over cracked glaciers, past Gore-Tex’d climbers, into the thin air at 15,781 feet — and back home again in less than seven hours, a trip that mountaineers can spend days to complete. A few years ago Jornet ran the 165-mile Tahoe Rim Trail and stopped just twice to sleep on the ground for a total of about 90 minutes. In the middle of the night he took a wrong turn, which added perhaps six miles to his run. He still finished in 38 hours 32 minutes, beating the record of Tim Twietmeyer, a legend in the world of ultrarunning, by more than seven hours. When he reached the finish line, he looked as if he’d just won the local turkey trot.
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Levon Biss for The New York Times
Jornet “is not normal,” his mother says. “My mission is to make Kilian tired. Always, I was tired, but Kilian, no.”
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Levon Biss for The New York Times
Jornet in Pelvoux, France, for the I.S.M.F. World Ski Mountaineering Championships last month.
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Come winter, when most elite ultrarunners keep running, Jornet puts away his trail-running shoes for six months and takes up ski-mountaineering racing, which basically amounts to running up and around large mountains on alpine skis. In this sport too, Jornet reigns supreme: he has been the overall World Cup champion three of the last four winters.
So what’s next when you’re 25 and every one of the races on the wish list you drew up as a youngster has been won and crossed out? You dream up a new challenge. Last year Jornet began what he calls the Summits of My Life project, a four-year effort to set speed records climbing and descending some of the world’s most well known peaks, from the Matterhorn this summer to Mount Everest in 2015. In doing so, he joins a cadre of alpinists like Ueli Steck from Switzerland and Chad Kellogg from the United States who are racing up peaks and redefining what’s possible. In a way, Jornet says, all of his racing has been preparation for greater trials. This month, he is in the Himalayas with a couple of veteran alpinists. They plan to climb and ski the south face of a peak that hasn’t been skied before in winter.
But bigger challenges bring bigger risks. Less than a year ago, Jornet watched as his hero and friend Stéphane Brosse died in the mountains. Since then, he has asked himself, How much is it worth sacrificing to do what you love?
Chamonix, France, is a resort town wedged into a narrow valley at the foot of Mont Blanc, just over an hour’s drive southeast of Geneva. For those who adore high mountains, the place is hallowed. The Rue du Docteur Paccard is named for one of the first men to ascend Mont Blanc, in 1786; millionaires are tolerated, but mountain men are revered. The valley is Jornet’s home for the few months each year when he is not traveling. I met him there on a stormy morning in December, when he drove his dented Peugeot van into a parking lot at the edge of town, stepped out and offered a shy handshake. He is slight and unremarkable in the deceptive way of a Tour de France cyclist — he’s 5-foot-6 and 125 pounds — with the burnished complexion of years spent above the tree line and a thatch of black hair that, when sprung from a ski hat, has a slightly blendered look.
The Marvels in Your Mouth
By MARY ROACH
Published: March 25, 2013 17 Comments
WAGENINGEN, THE NETHERLANDS — When I told people I was traveling to Food Valley, I described it as the Silicon Valley of eating. At this cluster of universities and research facilities, nearly 15,000 scientists are dedicated to improving — or, depending on your sentiments about processed food, compromising — the quality of our meals.
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Gulp! The Quiz
Chew, swallow, digest, repeat. Take this quiz to learn some of the amazing things that go on in your gut.
Science Times Podcast
Henry Fountain on how science is tracking the meteor that exploded over Russia back to its source; Mary Roach on our fascinating guts; Denise Grady on a novel treatment for some cancers of the blood.
8:00A Meteor’s Data Trail
11:22Journey on the Alimentary Canal
9:07Using the Body to Fight Cancer
The Mouth’s Guard (March 26, 2013)
Do you have a question for Mary Roach about the wonders of chewing, swallowing and other aspects of human eating? Post a question for her here and she will answer a selection in an upcoming video interview on nytimes.com.
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At the time I made the Silicon Valley comparison, I did not expect to be served actual silicone.
But here I am, in the Restaurant of the Future, a cafeteria at Wageningen University where hidden cameras record diners as they make decisions about what to eat. And here it is, a bowl of rubbery white cubes the size of salad croutons. Andries van der Bilt has brought them from his lab in the brusquely named Department of Head and Neck, at the nearby University Medical Center Utrecht.
“You chew them,” he said.
The cubes are made of a trademarked product called Comfort Putty, more typically used in its unhardened form for taking dental impressions. Dr. Van der Bilt isn’t a dentist, however. He is an oral physiologist, and he likely knows more about chewing than anyone else in the world. He uses the cubes to quantify “masticatory performance” — how effectively a person chews.
I take a cube from the bowl. If you ever, as a child, chewed on a whimsical pencil eraser in the shape of, say, an animal or a piece of fruit, then you have tasted this dish.
“I’m sorry.” Dr. Van der Bilt winces. “It’s quite old.” As though fresh silicone might be better.
Dr. Van der Bilt and his colleagues have laid claim to a strange, occasionally repugnant patch of scientific ground. They study the mouth — more specifically, its role as the human food processor. Their findings have opened up new insights into quite a few things that most of us do every day but would rather not think about.
The way you chew, for example, is as unique and consistent as the way you walk or fold your shirts. There are fast chewers and slow chewers, long chewers and short chewers, right-chewing people and left-chewing people. Some of us chew straight up and down, and others chew side-to-side, like cows. Your oral processing habits are a physiological fingerprint.
Gun deaths are shaped by race in America. Whites are far more likely to shoot themselves, and African Americans are far more likely to be shot by someone else.The statistical difference is dramatic, according to a Washington Post analysis of data from the U.S. Centers for Disease Control and Prevention. A white person is five times as likely to commit suicide with a gun as to be shot with a gun; for each African American who uses a gun to commit suicide, five are killed by other people with guns. Where a person lives matters, too. Gun deaths in urban areas are much more likely to be homicides, while suicide is far and away the dominant form of gun death in rural areas. States with the most guns per capita, such as Montana and Wyoming, have the highest suicide rates; states with low gun ownership rates, such as Massachusetts and New York, have far fewer suicides per capita.Suicides and homicides are highly charged human dramas. Both acts shatter families, friends and sometimes communities. But the reactions are as different as black and white, and those differences shape the nation’s divided attitudes toward gun control.For instance, African Americans tend to be stronger backers of tough gun controls than whites. A Washington Post-ABC News poll this month found that about three-quarters of blacks support stronger controls, compared with about half of whites. The poll also found that two-thirds of city dwellers support stronger gun controls, while only about a third of rural residents back them.
McDonald’s may be the country’s No. 1 fast-food chain and one of its most-beloved brands, but when it comes to millennials, the Golden Arches says it doesn’t even rank among the demographic’s top 10 restaurant chains.
It’s enough of a concern that McDonald’s is launching its biggest product of the year, McWrap, to court a huge and influential cohort that values choice and customization. According to NPD Group, there are 59 million people ages 23 to 36 in the U.S. — the range it defines as millennials.
McDonald’s isn’t the only major marketer trying to reach millennials. Everyone from Coke and Gatorade to brewers and media companies are struggling to understand this group. There’s even confusion about just who millennials are in terms of age range (restaurant consultant Technomic counts them as 19-to-34-year-olds; McDonald’s, in an internal memo obtained by Advertising Age, classifies them as ages 18 to 32). Size estimates for this demographic group range anywhere from 59 million to 80 million.
So here’s my summary: Management only exists to compensate for its own poor hiring decisions. The Internet makes it easier to locate and then work with capable partners. Therefore, the need for management will shrink – at least for some types of businesses – because entrepreneurs have the tools to make fewer hiring mistakes in the first place.
Management won’t entirely go away, but as technology makes it easier to form competent teams without at least one disruptive or worthless worker in the group, the need for management will continue to decline.
After poor service, noise is the second leading complaint about restaurants. Proprietors believe that people spend more on food and drink in bustling eateries, and many have created new venues or retrofitted old ones to maximize sound levels.
When I’m told about a new restaurant, my first question is, “Is it noisy?” My friends and I will never return to one in which the racket makes it impossible to converse with tablemates. Perhaps the young diners the restaurateurs covet “talk” by texting.
The ears are fragile instruments. When sound waves enter the ear, they cause the eardrum to vibrate. The vibrations are transmitted to the cochlea, in the inner ear, where fluid carries them to neatly organized rows of hair cells. These in turn stimulate auditory nerve fibers, each attuned to a different frequency. These impulses travel via the auditory nerve to the brain, where they are interpreted as, say, words, music or an approaching vehicle.
Damage to this delicate apparatus results from both volume and length of exposure to sound. Very loud noises, or chronic exposure to sound even when it is not particularly loud, can wreak havoc on hair cells, causing them to become disarranged and to degenerate.
To the editor:
In Mr. Keller’s article [States Gone Wild, Monday, March 25] he repeatedly mentions his strong aversion to restrictive abortion rules…Has Mr. Keller previously shared his rationale for this strong opinion? For example, is it based on his interpretation of the Constitution or perhaps a personal understanding of when life commences. I ask if he might consider replying to this inquiry with a succinct summary of his position. Thank you.
This will not be “succinct,” or simple, or likely to satisfy anyone who can reduce abortion to a slogan.
The closest thing I have to a guiding text on the subject of abortion is not a volume of constitutional law or a summary of the latest biological research on the origins of life. It is a black, three-ring binder containing hundreds of letters from readers who lived and suffered with the subject.
The letters arrived in response to a column called “Charlie’s Ghost,” which The Times published on June 29, 2002. It recounted the decision my wife and I made to end a badly troubled pregnancy, and the strong countervailing emotions that decision entailed.
The letters poured in, intimate and candid and heartfelt, full of experience and mercifully short of political cant or judgment. There were stories from parents who had given birth to children with the direst physical or mental defects; some rejoiced in the sacrifice, some lamented that this decision had brought misery to their families. There were letters from parents who had terminated pregnancies gone wrong; some were at peace with that choice, others never fully overcame the sense of guilt. If that volume of letters has a theme, it is something like: the heart grades on the curve.
The Destructive Influence of Imaginary Peers
By TINA ROSENBERG
Fixes looks at solutions to social problems and why they work.
ALCOHOL ABUSE, COLLEGES AND UNIVERSITIES, NORTHERN ILLINOIS UNIVERSITY, OPOWER
We humans irrationally think we’re rational. We think that we decide how to behave by weighing the pros and cons. In reality, the strongest influence on our decisions is the example of the people around us — even, oddly enough, when they are imaginary.
Like most universities, Northern Illinois University in DeKalb has a problem with heavy drinking. In the 1980s, the school was trying to cut down on student use of alcohol with the usual strategies. One campaign warned teenagers of the consequences of heavy drinking. “It was the ‘don’t run with a sharp stick you’ll poke your eye out’ theory of behavior change,” said Michael Haines, who was the coordinator of the school’s Health Enhancement Services. When that didn’t work, Haines tried combining the scare approach with information on how to be well: “It’s O.K. to drink if you don’t drink too much — but if you do, bad things will happen to you.”
That one failed, too. In 1989, 45 percent of students surveyed said they drank more than five drinks at parties. This percentage was slightly higher than when the campaigns began. And students thought heavy drinking was even more common; they believed that 69 percent of their peers drank that much at parties.
But by then Haines had something new to try. In 1987 he had attended a conference on alcohol in higher education sponsored by the United States Department of Education. There Wes Perkins, a professor of sociology at Hobart and William Smith Colleges, and Alan Berkowitz, a psychologist in the school’s counseling center, presented a paper that they had just published on how student drinking is affected by peers. “There are decades of research on peer influence — that’s nothing new,” Perkins said at the meeting. What was new was their survey showing that when students were asked how much their peers drank, they grossly overestimated the amount. If the students were responding to peer pressure, the researchers said, it was coming from imaginary peers.
Report Card on Health Care Reform
By THE EDITORIAL BOARD
Published: March 23, 2013 183 Comments
Republican leaders in Congress regularly denounce the 2010 Affordable Care Act and vow to block money to carry it out or even to repeal it. Those political attacks ignore the considerable benefits delivered to millions of people since the law’s enactment three years ago Saturday. The main elements of the law do not kick in until Jan. 1, 2014, when many millions of uninsured people will gain coverage. Yet it has already thrown a lifeline to people at high risk of losing insurance or being uninsured, including young adults and people with chronic health problems, and it has made a start toward reforming the costly, dysfunctional American health care system.
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EXPANDING COVERAGE Starting in 2010, all insurers and employers that offer dependent coverage were required to offer coverage to dependent children up to age 26. An estimated 6.6 million people ages 19 through 25 have been able to stay on or join their parents’ plans as result, with more than 3 million previously uninsured young adults getting health insurance. The law requires private health insurers to provide free preventive care, without co-pays or deductibles. Some 71 million Americans have received at least one free preventive service, like a mammogram or a flu shot, and an additional 34 million older Americans got free preventive services in 2012 under Medicare.
Private insurers are now required to cover children with pre-existing conditions, which means that an estimated 17 million such children have been protected against being uninsured.
And more than 107,000 adults have enrolled in a federally run insurance plan for people with pre-existing conditions. The law also bars insurers from canceling policies on sick people; previously, 10,000 people a year had their policies rescinded.
The law appropriated $11 billion over five years to build and operate community health centers, a major factor in increasing the annual number of patients served to 21 million, a rise of 3 million from previous levels. Some $5 billion has been put into a reinsurance program that has encouraged employers to retain coverage for retirees and their families; 19 million people benefited with reduced premiums or cost-sharing.
These shifts suggest that the way markets distribute rewards is neither divinely determined nor purely the result of the “invisible hand.” It is determined by laws, regulations, technology, norms of behavior, power relationships, and the ways that labor and financial markets operate and interact. These arrangements change over time and can dramatically affect market outcomes and incomes.
This poses a dilemma for those making a moral case for free markets. If providers of capital could lay a moral claim to 25 percent of the nation’s income as recently as the early 1990s, why do they have a moral claim to 35 percent today? If the top five executives in a big public corporation could once lay claim to 2 or 3 percent of its profits, what gives them the moral right to 10 percent today? And what possible moral justification could there be for a system in which, for every dollar of increased output resulting from higher worker productivity, a mere 13 cents now goes to the typical worker in higher pay and benefits?
Moral philosophers since Adam Smith have understood that free-market economies are not theoretical constructs — they are embedded in different political, cultural and social contexts that significantly affect how they operate. If there can be no pure free market, then it follows that there cannot be only one neutral or morally correct distribution of market income.
In our current debate over capitalism, too much attention is focused on whether, how or how much to redistribute the incomes that markets have produced, with too little focus on the institutional arrangements that determine how that income is divided up in the first place. Such a focus would take in everything from minimum-wage laws to labor laws to the rules of corporate governance. At this point, the markets’ uneven distribution of income has become so dramatic that it threatens to overwhelm the ability of a progressive tax-and-transfer system to keep up with it.
A useful debate about the morality of capitalism must get beyond libertarian nostrums that greed is good, what’s mine is mine and whatever the market produces is fair. It should also acknowledge that there is no moral imperative to redistribute income and opportunity until everyone has secured a berth in a middle class free from economic worries. If our moral obligation is to provide everyone with a reasonable shot at economic success within a market system that, by its nature, thrives on unequal outcomes, then we ought to ask not just whether government is doing too much or too little, but whether it is doing the right things.
The Shadowy Residents of One Hyde Park—And How the Super-Wealthy Are Hiding Their Money | Vanity Fair
t comes as a surprise to most people that the most important player in the global offshore system of tax havens is not Switzerland or the Cayman Islands, but Britain, sitting at the center of a web of British-linked tax havens, the last remnants of empire. An inner ring consists of the British Crown Dependencies—Jersey, Guernsey, and the Isle of Man. Farther afield are Britain’s 14 Overseas Territories, half of them tax havens, including such offshore giants as the Caymans, the British Virgin Islands (B.V.I.), and Bermuda. Still further out, numerous British Commonwealth countries and former colonies such as Hong Kong, with deep and old links to London, continue to feed vast financial flows—clean, questionable, and dirty—into the City. The half-in, half-out relationship provides the reassuring British legal bedrock while providing enough distance to let the U.K. say “There is nothing we can do” when scandal hits.
Data is scarce, but in the second quarter of 2009 the three Crown dependencies alone provided $332.5 billion in net financing to the City of London, much of it from tax-evading foreign money. Matters are so out of hand that in 2001 Britain’s own tax authorities sold off 600 buildings to a company, Mapeley Steps Ltd., registered in the tax haven of Bermuda to avoid tax.
Britain could close down this tax-haven secrecy overnight if it wanted, but the City of London won’t let it. “We have, to put it provocatively, a second British empire, which is at the very core of global financial markets today,” explains Ronen Palan, professor of international political economy at City University in London. “And Britain is very good at not advertising its position.”
Despite the British passion for historic preservation, the recent huge influx of foreign money is changing the capital, both physically and socially. “Our Georgian and Victorian stock is so inflexible, frozen in time,” said Ademir Volic, of Volume 3 Architects. “We’re selling this city as a forward-looking metropolis, yet we can’t change a single window in a conservation area. Everything has to be hidden underground.”
That’s just what the plutocrats are doing: digging down. Maggie Smith, of the London Basement company, which carries out basement renovations, dates the craze to the early to mid-1990s, when she noticed increasing numbers of people wanting to renovate their musty old basements. “It started quite small, with people doing 30 to 40 square meters, generally under the front of a standard Victorian London house,” she says. “Then they began digging out under parts of gardens, then entire gardens, installing light wells and glass bridges to bring in natural light.”
Soon they built underground recreation centers, golf-simulation rooms, squash courts, bowling alleys, hair salons, ballrooms, and car elevators to the underground garages for their vintage Bentleys. The more adventurous installed climbing walls and indoor waterfalls.
“They would dig deep, have a media room and a funny sort of spring-loaded garage or a swimming pool,” says Peter York. “And they would disturb the water table. You can imagine what old-fashioned British toffs thought of that.” One Knightsbridge resident—and tension is such that he declines to identify himself or his street—says that on his short street of 15 or 20 properties he has recently suffered through nine simultaneous renovations.
Cable-TV mogul David Graham outraged his neighbors, near Lennox Gardens Mews, south of One Hyde Park, by seeking planning permission to excavate deeper than the height of neighboring homes, extending all the way under his house and garden. The Duchess of St. Albans, a neighbor, calls the plans “absolutely monstrous and unnecessary.” So far, permission has not been granted.
On March 19, 2003, as troops packed gear into their trucks on the Iraq-Kuwait border and loaded weapons for combat, President George W. Bush told the American people he had given the order to attack.
“At this hour, American and coalition forces are at the early stages of military operations to disarm Iraq, to free its people, and to defend the world from grave danger,” he said.
Ten years later, however, it is clear that most of the reasons given for the second post-9/11 war were dubious at best.
Rachel Maddow recently aired a documentary (which will re-air on Mar. 22 at 9 EST) called Hubris: Selling the Iraq War, in which she reminds us of how we got to that moment.
The head of the Navy’s Pacific fleet called climate change the most significant threat to long-term security in that region.Navy Admiral Samuel J. Locklear III made the comments Friday in an interview with The Boston Globe.He said that turmoil from climate change “is probably the most likely thing that is going to happen . . . that will cripple the security environment, probably more likely than the other scenarios we all often talk about.’’From the Globe:“People are surprised sometimes,” he added, describing the reaction to his assessment. “You have the real potential here in the not-too-distant future of nations displaced by rising sea level. Certainly weather patterns are more severe than they have been in the past. We are on super typhoon 27 or 28 this year in the Western Pacific. The average is about 17.”That’s not to say Locklear isn’t also concerned about North Korea’s nuclear weapons testing, the rift between China and Japan regarding a set of small islands and computer hacking associated with China.But Locklear’s worries about climate change align with many other warnings from the armed forces and Defense Department.The Defense Department outlined climate change as a national security threat in the Quadrennial Defense Review it released in 2010.Military branches also have shifted to adopt more clean-energy technology in an attempt to reduce the armed services’ emissions.
When people get more education, they become more productive and help strengthen the entire U.S. economy. So it is discouraging to see that students from wealthy families are increasingly more likely to graduate from college than are those from poor families. This perpetuates inequality from one generation to the next and limits the economic benefits that could come if a wider swath of the population earned college degrees.
The widening gap in college completion rates is documented in a paper by economists Martha Bailey and Susan Dynarski of the University of Michigan. Looking at children born in the early 1960s, the researchers found that only 5 percent of children from families in the lowest-income quartile completed college, while 36 percent of those from families in the highest-income quartile did.
For children born around 1980, the college completion rate among low-income students rose to 9 percent, but among high- income students it jumped to more than half (54 percent). In other words, over two decades, the college income gap widened to 45 percentage points from 31 percentage points. This widening was observed even after the researchers accounted for differences in students’ cognitive skills.
It’s tempting to conclude that the advantages of wealth and income have simply intensified, so the odds are increasingly stacked against poorer students. No doubt that’s true to some extent, but Bailey and Dynarski show that most of the change has been driven by trends among female students. The gap between rich and poor in both college entry and college completion widened by almost twice as much for women as it did for men. (An astonishing 85 percent of girls born in well-off families around 1980 entered college.)
According to an article published by the Washington Times, the F-35A, the Conventional Take Off and Landing version of the Joint Strike Fighter, would be defeated in aerial combat because of its current shortcomings.
Mentioning a leaked Pentagon report made available by POGO, the article explains that “out-of-cockpit visibility in the F-35A is less than other Air Force fighter aircraft,” thus limiting a pilot’s ability to see aerial threats surrounding him.
The problem is in the large head rest that impedes rear visibility and the ability of the pilot to check the aircraft’s 6 o’clock for incoming aerial or surface threats.
Another shortcoming is the aircraft adveniristic helmet mounted display system (HMDS Gen. II), that has not yet solved focal problems, blurry and double vision in the display and misalignment of the virtual horizon display with the actual horizon.
The HMDS Gen. II integrates FLIR (Forward Looking Infra Red) and DAS (Distributed Aperture System) imaging, and night vision (without somehow uncomfortable NVGs – Night Vision Goggles) into a single helmet in which essential flight and weapon aiming information are project onto a virtual HUD (Head Up Display) on the visor.
Flawed F-35 Fighter Too Big to Kill as Lockheed Hooks 45 States
By Kathleen Miller, Tony Capaccio & Danielle Ivory – Feb 22, 2013 12:08 PM PT
The Pentagon envisioned the F-35 Joint Strike Fighter as an affordable, state-of-the-art stealth jet serving three military branches and U.S. allies.
Instead, the Lockheed Martin Corp. (LMT) aircraft has been plagued by a costly redesign, bulkhead cracks, too much weight, and delays to essential software that have helped put it seven years behind schedule and 70 percent over its initial cost estimate. At almost $400 billion, it’s the most expensive weapons system in U.S. history.
In this image released by the U.S. Navy courtesy of Lockheed Martin, the U.S. Navy variant of the F-35 Joint Strike Fighter, the F-35C, conducts a test flight over the Chesapeake Bay. Source: U.S. Navy/Lockheed Martin via Getty Images
Dec. 10 (Bloomberg) — Bloomberg’s Erik Schatzker reports that the Pentagon is close to greenlighting a deal that calls for 29 new F-35 fighter jets in fiscal 2013. (Source: Bloomberg)
Feb. 22 (Bloomberg) — Megan Hughes reports on a Bloomberg Poll about the looming sequester spending cuts and the economics of the F35 Fighter Jet. She speaks on Bloomberg Television’s “In The Loop.” (Source: Bloomberg)
Attachment: Graphic: No Program Left Behind
A visitor to the Singapore Airshow speaks on a mobile phone near Lockheed Martin Corp.’s F-35 Joint Strike Fighter in Singapore. Photographer: Scott Eells/Bloomberg
(L-R) Commandant of the Marine Corps General James F. Amos, U.S. Senator John McCain, a Republican from Arizona, and Marine Fighter Attack Squadron 121 Commanding Officer Lt. Col. Jeffrey Scott stand near an F-35B at Marine Corp Air Station in Yuma, Arizona. Source: Lockheed Martin via Bloomberg
GRAPHIC: No Program Left Behind
Capt. Louis Renault’s famous line in the movie “Casablanca” comes to mind as I behold the reaction to the journalist Steven Brill’s 36-page report “Bitter Pill: Why Medical Bills Are Killing Us,” published in a special issue of Time last week. Mr. Brill was swiftly invited to appear on “The Daily Show with Jon Stewart” and on “Charlie Rose.”
Perspectives from expert contributors.
Americans are shocked, just shocked. But what they should have known for years is that in most states, hospitals are free to squeeze uninsured middle- and upper-middle-class patients for every penny of savings or assets they and their families may have. That’s despite the fact that the economic turf of these hospitals – for the most part so-called nonprofit hospitals – is often protected by state Certificate of Need laws that bestow on them monopolistic power by keeping new potential competitors at bay.
As George Bernard Shaw, whose works include “The Doctor’s Dilemma,” might have put it, that any lawmaker would grant hospitals monopolistic powers plus the freedom to price as they see fit is enough to make one despair of political humanity.
Mr. Brill vividly illustrates the harsh financial mauling that the hospitals covered in his report – all nonprofits – visit on uninsured middle-class Americans stricken with serious illness.
Often these people operate small businesses or are entrepreneurs in start-ups and cannot afford anything other than skimpy health insurance with strict upper limits on coverage. When they fall ill and require hospitalization, they become easy marks for what I think of as “extreme billing.”
In fairness, let me note that we cannot be sure whether the vignettes Mr. Brill presents are representative of the entire hospital industry or the policies of the proverbial few bad apples, a line that may well be taken by representatives of the hospital industry.
It does not take away from Mr. Brill’s brilliant journalism – especially his use of the Form 990 on which nonprofit hospitals must report their financial performance to the Internal Revenue Service – nor from Time’s brilliant marketing to note that the practices Mr. Brill reports have been well known to health-policy analysts and health-policy makers for at least a decade. And they should have been known to broad segments of the public as well – certainly to news organizations.
As early as 2003, Marilyn Werber Serafini’s “Health Care — Sticker Shock” was published in The National Journal, which is well known to Congressional lawmakers and their staffs.
Also in 2003, The Wall Street Journal began publishing on its front page a series of investigative reports by a staff reporter, Lucette Lagnado. In one article she reported on patients being hounded by collection agencies and their lawyers, only to end up in jail for failing to make court appearances in connection with their hospital bills.
Yale-New Haven Hospital, prominently mentioned in Mr. Brill’s report, was featured in one of Ms. Lagnado’s sad stories. I wish Yale University, where I received my doctorate, would withdraw its hallowed name from that legally independent hospital.
A Multi-Wavelength View of Radio Galaxy Hercules A | Deep-Space Photos: Hubble’s Greatest Hits | TIME.com
Deep-Space Photos: Hubble’s Greatest Hits
One of the few things Republicans and Democrats have been able to agree on in recent years is that the government should be spending more on basic scientific research — the sort of research that, in the past, has played a role in everything from mapping the human genome to laying the groundwork for the Internet.
Should the government be funding this sort of work? (AP)
“Government funding for basic science has been declining for years,” Mitt Romney wrote in his 2010 book No Apology. “It needs to grow instead.” In his most recent State of the Union address, President Obama sounded a similar note: “Now is the time to reach a level of research and development not seen since the height of the space race.”
So it’s notable that the exact opposite is, in fact, about to occur. Thanks to budget pressures and the looming sequester cuts, federal R&D spending is set to stagnate in the coming decade. The National Institutes of Health’s budget is scheduled to drop 7.6 percent in the next five years. Research programs in energy, agriculture and defense will decline by similar amounts. NASA’s research budget is on pace to drop to its lowest level since 1988.
As a result, scientists and other technology analysts are warning that the United States could soon lose its edge in scientific research — and that the private sector won’t necessarily be able to pick up the slack.
“If you look at total R&D growth, including the corporate and government side, the U.S. is now at the low end,” says Rob Atkinson, president of the Information Technology and Innovation Foundation (ITIF). “We’re seeing other countries, from Germany to Korea to China, make much bigger bets. And if that persists for long enough, it’s going to have an impact.”
via The coming R&D crash.
LOS ANGELES — A generation ago, California voters approved a ballot initiative that was seen as the most anti-immigrant law in the nation. Immigrants who had come to the country illegally would be ineligible to receive prenatal care, and their children would be barred from public schools.
Hispanics: California’s Next Majority
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Monica Almeida/The New York Times
Carlos Amador, who works as an organizer at the Downtown Labor Center of the University of California, Los Angeles.
But the law, which was later declared unconstitutional by the federal courts, never achieved the goal of its backers: to turn back the tide of immigrants pouring into the state. Instead, since the law was approved in 1994, the political and social reality has changed drastically across the state. Now, more California residents than ever before say that immigrants are a benefit to the state, according to public opinion polls from the Public Policy Institute of California.
As Congress begins debating an overhaul of the immigration system, many in California sense that the country is just now beginning to go through the same evolution the state experienced over the last two decades. For a generation of Republicans, Gov. Pete Wilson’s barrages on the impact of immigration in the 1990s spoke to their uneasiness with the way the state was changing. Now many California Republicans point to that as the beginning of their downfall.
Today, party leaders from both sides, and from all over the state, are calling for a softer approach and a wholesale change in federal policies.
The state’s changing attitudes are driven, in large part, by demographics. In 1990, Latinos made up 30 percent of the state’s population; they will make up 40 percent — more than any other ethnic group — by the end of this year, and 48 percent by 2050, according to projections made by the state this month. This year, for the first time, Latinos were the largest ethnic group applying to the University of California system.
WASHINGTON — Incomes rose more than 11 percent for the top 1 percent of earners during the economic recovery, but not at all for everybody else, according to new data.The numbers, produced by Emmanuel Saez, an economist at the University of California, Berkeley, show overall income growing by just 1.7 percent over the period. But there was a wide gap between the top 1 percent, whose earnings rose by 11.2 percent, and the other 99 percent, whose earnings declined by 0.4 percent.Mr. Saez, a winner of the John Bates Clark Medal, an economic laurel considered second only to the Nobel, concluded that “the Great Recession has only depressed top income shares temporarily and will not undo any of the dramatic increase in top income shares that has taken place since the 1970s.”The disparity between top earners and everybody else can be attributed, in part, to differences in how the two groups make their money. The wealthy have benefited from a four-year boom in the stock market, while high rates of unemployment have continued to hold down the income of wage earners.“We have in the middle basically three decades of problems compounded by high unemployment,” said Lawrence Mishel of the Economic Policy Institute, a left-of-center research group in Washington. “That high unemployment we know depresses wage growth throughout the wage scale, but more so for the bottom than the middle and the middle than the top.”In his analysis, Mr. Saez said he saw no reason that the trend would reverse for 2012, which has not yet been analyzed. For that year, the “top 1 percent income will likely surge, due to booming stock prices, as well as retiming of income to avoid the higher 2013 top tax rates,” Mr. Saez wrote, referring to income tax increases for the wealthy that were passed by Congress in January. The incomes of the other “99 percent will likely grow much more modestly,” he said.Excluding earnings from investment gains, the top 10 percent of earners took 46.5 percent of all income in 2011, the highest proportion since 1917, Mr. Saez said, citing a large body of work on earnings distribution over the last century that he has produced with the economist Thomas Piketty of the Paris School of Economics.Concern for the declining wages of working Americans and persistent high levels of inequality featured heavily in President Obama’s State of the Union address this week. He proposed raising the federal minimum wage to $9 from $7.25 as one way to ameliorate the trend, a proposal that might lift the earnings of 15 million low-income workers by the end of 2015.
The Secret to Fixing Bad Schools
By DAVID L. KIRP
WHAT would it really take to give students a first-rate education? Some argue that our schools are irremediably broken and that charter schools offer the only solution. The striking achievement of Union City, N.J. — bringing poor, mostly immigrant kids into the educational mainstream — argues for reinventing the public schools we have.
Union City makes an unlikely poster child for education reform. It’s a poor community with an unemployment rate 60 percent higher than the national average. Three-quarters of the students live in homes where only Spanish is spoken. A quarter are thought to be undocumented, living in fear of deportation.
Public schools in such communities have often operated as factories for failure. This used to be true in Union City, where the schools were once so wretched that state officials almost seized control of them. How things have changed. From third grade through high school, students’ achievement scores now approximate the statewide average. What’s more, in 2011, Union City boasted a high school graduation rate of 89.5 percent — roughly 10 percentage points higher than the national average. Last year, 75 percent of Union City graduates enrolled in college, with top students winning scholarships to the Ivies.
As someone who has worked on education policy for four decades, I’ve never seen the likes of this. After spending a year in Union City working on a book, I believe its transformation offers a nationwide strategy.
Ask school officials to explain Union City’s success and they start with prekindergarten, which enrolls almost every 3- and 4-year-old. There’s abundant research showing the lifetime benefits of early education. Here, seeing is believing.
He just had a different concept of political virtue. It would be nice, he writes, if a political leader could practice the Christian virtues like charity, mercy and gentleness and still provide for his people. But, in the real world, that’s usually not possible. In the real world, a great leader is called upon to create a civilized order for the city he serves. To create that order, to defeat the forces of anarchy and savagery, the virtuous leader is compelled to do hard things, to take, as it were, the sins of the situation upon himself.
The leader who does good things cannot always be good himself. Sometimes bad acts produce good outcomes. Sometimes a leader has to love his country more than his soul.
Since a leader is forced by circumstances to do morally suspect things, Machiavelli at least wants him to do them effectively. Machiavelli is full of advice. If you have to do something cruel, do it fast; if you get to do something generous, do it slowly. If you lead a country, you have more to fear from the scheming elites than the masses, so you should try to form an alliance with the people against the aristocracy.
When you read Machiavelli, you realize how lucky we are. Unlike 16th-century Florence, we have a good Constitution that channels conflict. We have manners, respect for law and social trust that softens behavior, at least a bit. Even in the realm of foreign affairs, we’ve inherited an international order that restrains conflict. Our ancestors behaved savagely to build our world, so we don’t have to.
But it’s still not possible to rule with perfectly clean hands. There are still terrorists out there, hiding in the shadows and plotting to kill Americans. So even today’s leaders face the Machiavellian choice: Do I have to be brutal to protect the people I serve? Do I have to use drones, which sometimes kill innocent children, in order to thwart terror and save the lives of my own?
When Barack Obama was a senator, he wasn’t compelled to confront the brutal logic of leadership. Now in office, he’s thrown into the Machiavellian world. He’s decided, correctly, that we are in a long war against Al Qaeda; that drone strikes do effectively kill terrorists; that, in fact, they inflict fewer civilian deaths than bombing campaigns, boots on the ground or any practical alternative; that, in fact, civilian death rates are dropping sharply as the C.I.A. gets better at this. Acting brutally abroad saves lives at home.
In no particular order…
1. As of January 2013, there are 16 people left in the world who were born in the 1800s, according to the Gerontology Research Group. With dividends reinvested, U.S. stocks have increased 28,000-fold during their lifetimes.
2. If you divide their net worths by their age, Carlos Slim and Bill Gates have each accumulated more than $100,000 in net worth for every hour they’ve been alive.
3. According to Forbes, if a Google employee passes away, “their surviving spouse or domestic partner will receive a check for 50% of their salary every year for the next decade.”
But the bigger problem is an ideological block. Conservatives love markets too much to admit that the health-care market can’t be made to work very well. Doctors face an array of legal and economic incentives to overtreat. Patients lack good information on both prices and effectiveness. They’re also intimidated by highly educated providers whose advice they reject at their peril. Records are a mess, leading to repeat testing and treatment decisions made in the absence of valuable information.
Not all of these problems with the market can be fixed through better policy. Economic incentives for overtreatment don’t just come from subsidies. They come in part from the fact that an individual’s health-care costs are unpredictable, requiring insurance, and that health risks are much harder to underwrite than, say, driving risks. In other cases, problems in the market come from policies that nobody wants to change; few people want to completely eliminate government backstops that finance care for people who cannot afford it, even though these subsidies distort the market.
Because the health-care market cannot be made to work things out on its own; approaches to health-care cost control have to be holistic. You have to figure out how the market can be improved so it leads to better consumption outcomes, where valuable market forces are being inhibited, and when top-down regulation is the best solution to address a market that is malfunctioning. Yet when conservatives talk about health-care cost control, their first and only instinct is to shout “markets markets markets.” The result is that conservative approaches to cost control are never really going to be any good.
It’s a symptom of a broader problem: On the topic of regulation, conservatives are stuck in the 1970s. At that time, the federal government was imposing lots of dumb regulations of markets that really should have been left to work without interference: trying to control inflation through wage and price controls, setting airline fares and shipping rates, telling banks how much interest they could pay on savings accounts.