As we noted in the context of antibiotics, it's well recognized that financial incentives cause the pharmaceutical industry to engage in research that tends to maximize profits rather than maximizing the health of the public. But a widely-circulated article in the Washington Post reveals another kind of bias that may stop us from adopting better ways of keeping people healthy that would also reduce healthcare costs.
This flows from the fact that countries with advanced healthcare systems are no longer dealing mainly with infectious diseases like turberculosis, as they once did, but with chronic ones like heart disease, diabetes, AIDS and many cancers. The key here is how best to manage the disease, particularly among elderly patients, and for that, doctors in hospitals aren't necessarily the best way:
Medicine has been so focused on what doctors can do in the hospital that it has barely even begun to figure out what can be done in the home. But the home is where elderly patients spend most of their time. It's where they take their medicine and eat their meals, and it's where they fall into funks and trip over the corner of the carpet. It's where a trained medical professional can see a bad turn before it turns into a catastrophe. Medicine, however, has been reluctant to intrude into homes.
One company, Health Quality Partners, has focused on doing precisely that:
The program enrolls Medicare patients with at least one chronic illness and one hospitalization in the past year. It then sends a trained nurse to see them every week, or every month, whether they're healthy or sick. It sounds simple and, in a way, it is. But simple things can be revolutionary.
The results certainly are:
According to an independent analysis by the consulting firm Mathematica, HQP has reduced hospitalizations by 33 percent and cut Medicare costs by 22 percent.
And yet Medicare is planning to shelve this pilot program, citing various bureaucratic reasons why it can't continue. Although some supporters of the home-based system maintain that it would be possible to overcome these problems, there remains a more fundamental obstacle to rolling out the Health Quality Partners approach more widely:
Hospitals make money when they do more to patients. They lose money when their beds are empty. Put simply, Health Quality Partners makes hospitals lose money.
So again we seem to be confronted by perverse incentives at the heart of our current healthcare. The better and cheaper way would mean scaling back key parts of the system by instituting regular home visits by nurses, thus reducing the number people sent into hospitals to be treated by physicians. That implies taking on very profitable and thus very powerful business interests, including the doctors themselves. Given that resistance, and Medicare's apparent reluctance to force change by backing the Health Quality Partners system, it seems likely that we will be stuck with an inferior, more costly approach to treating chronic diseases despite knowing what looks like a much better way to do it. Some might call that pretty sick.
Officially, the Chief Negotiators have backed off the prior commitment to end the TPP negotiation by October, but are still clinging to a goal to end the negotiation by the “end of the year.” But privately, none of the negotiators or stakeholders at this round would express any confidence that the intellectual property issues could be resolved by then. The issues still under contention are massive.Furthermore, it appears that some of the negotiators are realizing that it's a bad idea to lock in certain concepts, as would be set under the TPP, especially as various court rulings are changing the way copyright laws are viewed, and while a new copyright reform process is ongoing. People seem to be recognizing that agreeing to specific norms that may quickly be undermined by national laws would be a waste of time.
The intellectual property chapter has grown to over 80 pages of text – including all the bracketed suggestions and alternatives. Some negotiators describe it as the longest text currently under negotiation.
Many of the issues are completely blocked. There has not been any new negotiation text offered on the most controversial pharmaceutical provisions since the Melbourne round over a year ago. There is currently no mandate from many countries to negotiate (they only “consult” and “discuss”) the pharmaceutical reimbursement chapter. Barbara Weisel described the pharmaceutical issues as being in a “period of reflection,” and had no comment on when that period might end.
The recent spate of proposals for policy changes for US copyright law have caused a stir. The US is being asked how it can hold on to demands for parallel importation restrictions after the Kirtsaeng ruling, 70 year copyright terms after the Copyright Office proposed shifting them back to 50 years with formalities required for extensions, and strict restrictions on anti-circumvention liability exceptions when the Obama Administration and the Library of Congress have endorsed reforms that would violate the US proposal. Barbara Weisel stated that USTR is “doing what we can to work with Congress” to make sure that the TPP will not restrict policy options. But negotiators have said that there has been no visible movement on the USTR’s positions on Copyright issues, which will be negotiated this week.And, of course, once again, the USTR appears to have no plans to be transparent in the slightest.
And there is no plan to release any text to the public. This is stark contrast to the last to plurilateral agreements including countries in the region. The Free Trade Area for the Americas and the Anti-Counterfeiting Trade Agreement both released full texts of the negotiating document with brackets indicating text under consideration before the finalization of the texts. For ACTA, there were four publicly released texts between April 2010 and May 2011. For the TPP – none yet, despite the Chief Negotiators’ pronouncement of end of year finalization plans.Considering how much controversy there is over these items, it seems ridiculous that we still can't actually see what's being negotiated in our name -- especially when there's quite reasonable fears that it could mess with the democratic process of potentially rewriting copyright law.
Criminal Nabbed By His Own Food Porn (Failures)
They came up on the IRS radar after the couple met an informant at — no joke — YOLO Restaurant in Fort Lauderdale. Maye told the informant his name was Troy and that he had stolen 700,000 identities, but the IRS could not yet crack the thief of identities' identity.I have no idea what kind of food is served at YOLO Restaurant, but you kind of have to assume everything on the menu has a 50/50 shot of killing you, right? Maybe it's nothing but puffer fish and uncooked chicken with a side of ebola? Regardless, the IRS still wasn't able to get names on the two, so the informant was sent to have another meal with the two criminals, this time upping the classiness of the operation by going to a Morton's Steakhouse. While there, Maye provided the informant with a thumb drive that contained a bunch of identities, which were promptly turned over to the IRS. Investigators were then able to pull Maye's name from metadata on the drive. From there, the IRS did what any federal agency would do:
IRS Agent Louis Babino then headed to Google and located Maye’s Instagram page, which contained a profile photo of Maye. When shown the profile photo, the CW confirmed that Maye (seen at right) was the man with whom he dined at Morton’s.Well, sure, Agent Babino, but how can you be really sure this was your guy?
A further review of Maye’s Instagram page, Babino noted, revealed “a photo of a steak and macaroni and cheese meal containing the caption ‘Morton’s.’” The image--uploaded on January 7 at 11:24 PM--“appears to coincide” with the CW’s meeting at Morton’s, added Babino.Yup, this guy food-porned his way into being arrested. The Instagram photo is reportedly being entered into evidence in the case, so one hopes the juicy steak and the creamy mac and cheese was really, really worth all the trouble Maye is now in. Once again, if you're a criminal, online narcicism is probably something you'd do best to avoid.
When we typically discuss companies coming to blows with content control (aka censorship), the stories tend to be about what would otherwise be obscure wrong-doings going viral on a national or international level. Major automakers concocting horrible advertising around suicide, for instance. Or multi-state bus companies learning that bathroom-ing on their customers isn't the best practice and catching the resulting backlash. But the practice of shining the light on yourself by being overly protective of your brand doesn't only happen at the macro level, it can have a local effect as well.
That's the lesson the Chicago Blackhawks are learning right this very minute. If you're not in Chicago, you probably haven't heard of Susannah Collins, who reports for Comcast Sports Net on the Blackhawks. In fact, if you know who she is at all, it's probably from this line of low-brow comedy videos that she produced on YouTube. While some of those videos are likely NSFW, there is nothing more racy in them than a bit of colorful language and suggestive talk. It's about as harmless as it gets. That is, of course, unless you're the Chicago Blackhawks who, for reasons that make absolutely zero sense, decided that those videos surfacing were cause to five-hole Collins' career and have her fired.
In a letter to the Vice President/General Manager of Comcast Sports Net Chicago, team chairman Rocky Wirtz demanded that reporter Susannah Collins be removed immediately, citing his awareness of comedy videos made years earlier that he found “incredibly offensive to a number of audiences, going well beyond professional athletes.”
He only learned of them after her innocent, unfortunate slip of the tongue last week brought them back to the fore, but it didn’t matter to Wirtz. Although they had been a fully disclosed non-issue upon her hiring, they became instant, retroactive reason for a swift dismissal.The locals in Chicago were immediately upset over the firing. Certainly part of the reason for the animosity is the silliness of firing a reporter over sketch comedy videos she did on YouTube years ago. But, in true bad PR fashion, the real anger comes over the team's almost epic level of hypocrisy. You see, Wirtz cited the video's offensiveness as the reason for asking CSN (which is owned by several local Chicago teams, including the Blackhawks) to fire Collins. This, from the same team that has young women in tiny outfits shoveling up ice shavings between periods during games. This from a team that plays a sport in which fans will cheer on two grown men committing assault upon one another and then have the nerve to call it "part of the game."
Hull’s second wife, Joanne, whom he wed in 1960 and divorced in 1980, told an ESPN documentary in 2002 that she “took a real beating” at his hands. She described an incident during which Hull “threw me in the room, and just proceeded to knock the heck out of me. He took my shoe – with a steel heel – and proceeded to hit me in the head. I was covered with blood. And I can remember him holding me over the balcony, and I thought this is the end, I’m going.” She filed to end the marriage in 1970 after several more incidents, but they reconciled until Hull threatened her with a loaded shotgun in 1978. Their daughter, Michelle, also described his pattern of behavior to “Sports Century,” and she now works as an attorney specializing in domestic violence.Should you think this was a one-time minor indiscretion of old-fashioned domestic abuse, Hull's second wife complained of similar treatment, Hull was later convicted for trying to punch a police officer, oh, and there was that one time he was all warm and fuzzy about freaking Hitler.